The patient was an 80-year-old man with scrotal and penile extramammary Paget’s disease and prostate cancer. Both diseases were in advanced stages. Tumor cells of extramammary Paget’s disease strongly expressed estrogen receptor α. The patient was concurrently treated with two kinds of hormonal therapy: the anti-estrogen tamoxifen (20 mg/day orally) for extramammary Paget’s disease and the anti-androgen bicalutamide (80 mg/day orally) for prostate cancer. The toxicity of the therapy was mild. All of the metastatic lesions remained stable for 2 months after initiation of dual hormonal therapy. During a follow-up period of 22 months, performance status was well maintained for 17 months. Hormonal therapy may be an alternative for selected cases of advanced extramammary Paget’s disease.

1.
Gatalica Z: Immunohistochemical analysis of apocrine breast lesions: consistent over-expression of androgen receptor accompanied by the loss of estrogen and progesterone receptors in apocrine metaplasia and apocrine carcinoma in situ. Pathol Res Pract 1997;193:753–758.
2.
Choudry R, Hodgins MB, Van der Kwast TH, Brinkmann AO, Boersma WJ: Localization of androgen receptors in human skin by immunohistochemistry: implication for the hormonal regulation of hair growth, sebaceous glands and sweat glands. J Endocrinol 1992;133:467–475.
3.
Shikata N, Kurokawa I, Andachi H, Tsubura A: Expression of androgen receptors in skin appendage tumors: an immunohistochemical study. J Cutan Pathol 1995;22:149–153.
4.
Fujimoto A, Takata M, Hatta N, Takehara K: Expression of structually unaltered androgen receptor in extramammary Paget’s disease. Lab Invest 2000;80:1465–1471.
5.
Leon ED, Carcangiu ML, Prieto VG, McCue PA, Burchette JM, To G, Norris BA, Kovatich AJ, Sanchez RL, Krigman HR, Gatalica Z: Extramammary Paget disease is characterized by the consistent lack of estrogen and progesterone receptor but frequently expresses androgen receptor. Am J Clin Pathol 2000;113:572–575.
6.
Lloveras B, Googe PB, Goldberg DE, Bhan AK: Estrogen receptors in skin appendage tumors and extramammary Paget’s disease. Mod Pathol 1991;4:487–490.
7.
Imakado S, Satomi H, Ishii Y, Aiyoshi Y, Otsuka F: Lack of progesterone receptor expression in extramammary Paget’s disease. Acta Derm Venereol 1999;79:399.
8.
Swanson PE, Mazoujian G, Mills SE, Campbell RJ, Wick MR: Immunoreactivity for estrogen receptor protein in sweat gland tumors. Am J Surg Pathol 1991;15:835–841.
9.
Remond B, Aractingi S, Blanc F, Verola O, Vignon D, Dubertret L: Umbilical Paget’s disease and prostatic carcinoma. Br J Dermatol 1993;128:448–450.
10.
Honda Y, Egawa K: Extramammary Paget’s disease not only mimicking but also accompanying condyloma acuminatum. Dermatology 2005;210:315–318.
11.
Sleater JP, Ford MJ, Beers BB: Extramammary Paget’s disease associated with prostate adenocarcinoma. Hum Pathol 1994;25:615–617.
12.
Nishi M, Tashiro M, Yoshida H: Stimulation of growth by both androgen and estrogen of the EMP-K1 transplantable tumor with androgen and estrogen receptors from human extramammary Paget’s disease in nude mice. J Natl Cancer Inst 1992;84:519–523.
13.
Caubet JF, Tosteson TD, Dong EW, Naylon EM, Whiting GW, Emstoff MS, Ross SD: Maximum androgen blockade in advanced prostate cancer: a meta-analysis of published randomized controlled trials using nonsteroidal antiandrogens. Urology 1997;49:71–78.
14.
Shirasaki F, Takata M, Ishii T, Fujimoto A, Hatta N, Takehara K: Total androgen blockade therapy for an advanced case of extramammary Paget’s carcinoma. Skin Cancer 2001;16:247–250.
15.
Hortobagyi GN: Treatment of breast cancer. N Engl J Med 1998;339:974–984.
16.
Hudis CA: Current status and future directions in breast cancer therapy. Clin Breast Cancer 2003;4:S70–S75.
17.
Sridhar KS, Benedetto P, Otrakji CL, Charyulu KK: Response of eccrine adenocarcinoma to tamoxifen. Cancer 1989;64:366–370.
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