Invasive extramammary Paget’s disease of the scrotum: A case report
Bibliographic record
Abstract
Extramammary Paget's disease is a rare cutaneous malignancy that typically presents as carcinoma in situ, and instances of invasive extramammary Paget's disease are exceptionally rare. Herein, we describe a rare case of invasive extramammary Paget's disease of the scrotum. A 91-year-old male presented with an over 10-year history of a granulomatous rash with serous discharge, refractory to various topical therapies and weekly wound care. Physical examination revealed a well-demarcated, erythematous, mamillated, eroded plaque with arcuate borders involving the left inguinal crease and scrotum. A punch biopsy showed intra-epidermal and invasive carcinoma with focal pagetoid spread and intracytoplasmic mucin. The favored diagnosis was primary, invasive extramammary Paget's disease. The patient underwent a wide local excision and routine imaging surveillance and remains recurrence-free at 1-year follow-up. Given that extramammary Paget's disease remains commonly misdiagnosed, leading to delays in treatment, dermatologists should be aware of this diagnosis, particularly for elderly patients presenting with non-specific genital lesions recalcitrant to routine treatment.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".