A case of apocrine adenocarcinoma on the genital region

An 88-year-old male developed an eczematoid lesion in the genital area about 3 years earlier but did not seek treatment because of no symptoms. In March 2006, he was referred to our department. At the initial examination, an infiltrative erythematous macule (57 X 42 mm) accompanied by erosion and a nodule was observed in the genital area. Differentiation from extramammary Paget's disease was necessary. However, since well-differentiated adenocarcinoma accompanied by decapitation secretion was observed immediately below the nodule, a diagnosis of apocrine adenocarcinoma and its Paget's phenomenon was made. Initially extensive resection was planned. However, his family did not desire active treatment because of his advanced age and dementia. Therefore, simple resection of the primary lesion with the least margin was performed. This patient made us realize again the difficulty in the treatment of malignant tumors with a poor prognosis in the elderly.