Neoadjuvant use of Imiquimod Before Surgery in Extramammary Paget’s Disease
Extramammary Paget's disease (EMPD) is a distinct form of a rare malignant skin neoplasm, primarily seen in postmenopausal Caucasian women. Surgery is the most common treatment. However, concerning vulvar EMPD, radical surgery can be mutilating and leads to loss of femininity. Recent therapeutic development has included medical and medical-surgical approaches, allowing better preservation of genital anatomy with subsequent reduced morbidity. Accordingly, off-label use of imiquimod has been reported as a monotherapy or adjuvant therapy in EMPD.
We report the case of a woman with extensive EMPD in the anogenital area, submitted to surgical resection complemented with plastic reconstruction and preceded by imiquimod medical treatment. Neoadjuvant imiquimod induced a significant cytoreduction of the tumor area, minimizing surgical radicality and maintaining local function and morphology
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