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目的介绍一种荧光法术前定位,手术切除联合光动力疗法治疗乳房外Paget病的经验。方法确诊为乳房外Paget病的59岁男性患者,皮损区避光外敷20%氨基酮戊酸3h,Wood氏灯下观察皮损区荧光反应,手术切除皮损,光动力疗法治疗6次。结果皮损区在Wood氏灯下呈砖红色荧光,边界清楚,手术联合光动力治疗后随访3年无复发。结论荧光定位法可提示肿瘤细胞侵犯范围,指导临床制定手术方案,术后联合光动力疗法杀灭可能残存的肿瘤细胞,减少复发率。
Objective To introduce a fluorescence preoperative localization and surgical resection combined with photodynamic therapy for extramammary Paget’s disease. Methods A 59-year-old man diagnosed with extramammary Paget’s disease was treated with 20% aminolevulinic acid for 3 hours in the skin of the lesion. Fluorescent reaction was observed under the Wood’s lamp, and skin lesions were removed by surgery. The photodynamic therapy was used for 6 times. Results The lesions showed brick-red fluorescence under Wood’s lamp, and the border was clear. There was no recurrence after 3-year follow-up with surgery and photodynamic therapy. Conclusion Fluorescent localization method can indicate the extent of tumor cell invasion, guide the clinical development of surgical options, combined with photodynamic therapy after surgery to kill possible residual tumor cells and reduce the recurrence rate.