Trastuzumab deruxtecan treatment for HER2-low metastatic scrotal extramammary Paget’s disease with bone marrow involvement: a case report - Report - MDSpire
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Treatment with Trastuzumab Deruxtecan for Metastatic HER2-Low Scrotal Extramammary Paget’s Disease Involving Bone Marrow: A Case Study

  • By

  • Yi Bao

  • Lei Zhang

  • Fenfen Jiang

  • Juanfen Mo

  • September 1, 2026

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Clinical Report: Treatment with Trastuzumab Deruxtecan for Metastatic HER2-Low Scrotal EMPD

Overview

This case study presents a 68-year-old man with metastatic scrotal extramammary Paget’s disease (EMPD) involving bone marrow, treated with trastuzumab deruxtecan (T-DXd). The patient maintained stable disease during treatment.

Background

Scrotal EMPD is a rare cutaneous adenocarcinoma that can metastasize and lead to severe complications, including bone marrow infiltration. The management of metastatic EMPD remains challenging, particularly in cases with low HER2 expression.

Data Highlights

No numerical data available in the source material.

Key Findings

  • The patient had localized pruritic scrotal lesions and systemic manifestations due to metastatic spread.
  • Histopathological assessment confirmed stage IV scrotal Paget’s disease with bone marrow involvement.
  • Immunohistochemistry revealed HER2 expression at 2+, but fluorescence in situ hybridization was negative.
  • Treatment with trastuzumab deruxtecan resulted in stable disease despite a substantial tumor burden.

Clinical Implications

Further research is warranted to establish optimal treatment protocols for this rare malignancy.

Conclusion

Continued investigation is essential to refine treatment strategies for this challenging condition.

Related Resources & Content

  1. Frontiers in Medicine, 2026 -- Metastatic extramammary Paget’s disease successfully treated by trastuzumab deruxtecan: a rare case report
  2. The ASCO Post, 2022 -- T-DXd Improves Progression-Free Survival vs T-DM1 in Metastatic HER2-Positive Breast Cancer
  3. Japanese Dermatological Association Guidelines, 2025 -- Clinical Questions of Guidelines for Extramammary Paget Disease
  4. the asco post — Case Study Shows Striking Improvements in Patient Treated for Metastatic Prostate Cancer With Antibody-Drug Conjugate
  5. the asco post — Trastuzumab Deruxtecan vs Physician’s Choice in HER2-Positive Metastatic Breast Cancer Previously Treated With Trastuzumab Emtansine
  6. Japanese Dermatological Association Guidelines: Clinical Questions of Guidelines for Extramammary Paget Disease 2025 - Matsushita - 2025 - The Journal of Dermatology - Wiley Online Library
  7. Phase II clinical trial of docetaxel and trastuzumab for HER2-positive advanced extramammary Paget’s disease (EMPD-HER2DOC) - PMC
  8. Clinicopathologic, molecular, and treatment features of metastatic and distantly recurrent extramammary Paget disease: Mayo clinic experience - PMC

Original Source(s)

Trastuzumab deruxtecan treatment for HER2-low metastatic scrotal extramammary Paget’s disease with bone marrow involvement: a case report

  • by Yi Bao, Lei Zhang, Fenfen Jiang, Juanfen Mo

  • September 1, 2026

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