Spontaneously Regressing Penile Extramammary Paget Disease without Recurrence of Primary Urothelial Carcinoma: A Case Report
Bibliographic record
Abstract
Introduction: Secondary extramammary Paget disease (EMPD) is a rare cutaneous malignancy that typically manifests on apocrine-rich skin originating from an underlying adenocarcinoma. It has a low chance of further metastasizing and treatment is recommended. Case Presentation: We present a case of an 86-year-old man with a history of bladder carcinoma that was successfully treated and in remission for 4 years, who developed an asymptomatic rash on the glans penis. Histopathology and immunohistochemistry confirmed secondary EMPD of urothelial origin. Cancer screening was negative and this was declared secondary EMPD without recurrence of primary malignancy. The patient declined surgical and pharmacologic treatment. After 1 year, the lesion spontaneously resolved with no recurrence. Conclusion: Secondary EMPD can present without underlying malignancy and may spontaneously regress. This is a rare phenomenon and the mechanism is not yet known. We speculate that it may be related to adaptive immunity, local inflammation promoted by biopsy and that there was no underlying primary malignancy. Treatment decisions should be made in the context of thorough goals of care discussions. Further observation of this phenomenon is required to guide management plans.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".