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HER‐2/neu expression in extramammary Paget disease: a clinicopathologic and immunohistochemistry study of 47 cases with and without underlying malignancy
Author(s) -
Plaza Jose A.,
TorresCabala Carlos,
Ivan Doina,
Prieto Victor G.
Publication year - 2009
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.2008.01148.x
Subject(s) - vulva , axilla , medicine , extramammary paget's disease , malignancy , scrotum , immunohistochemistry , pathology , breast cancer , cancer , dermatology , disease , surgery
Extramammary Paget disease (EMPD) is an infrequent skin cancer sometimes representing a secondary event caused by extension of an underlying carcinoma. Her‐2/neu overexpression in breast cancer is correlated with a more aggressive behavior, but anti‐Her‐2/neu therapy improves survival in these patients. We investigated Her‐2/neu expression by immunohistochemistry in cases of EMPD with and without underlying malignancy to try to correlate with tumor recurrence, progression and possible targeted therapy. Forty‐seven cases were analyzed (6 from the scrotum, 7 perianal region, 1 axilla and 33 vulva). Two cases had invasive EMPD (one from vulva and one from scrotum). The overall Her‐2/neu expression was 31.9%. Of the noninvasive EMPD of the vulva (32 cases), Her‐2/neu was shown in 38%. The case of invasive vulvar EMPD was negative. All six scrotal EMPD lacked Her2/neu expression. Her‐2/neu was expressed in two of seven perianal cases (33.3%). The EMPD on the axilla (one case) was negative. Eighteen cases had recurrence, and of these, 44.4% expressed Her‐2/neu in the initial lesion. A high proportion of EMPD showed Her‐2/neu expression (31.9%), indicating that these patients may benefit from targeted therapy. The proportion of positive cases was higher in lesions that had recurred at last follow up (44.4%), suggesting a more aggressive behavior.