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Invasive extramammary Paget's disease (EMPD) is highly metastatic to lymph nodes and other organs, including bone, and when metastatic lesions have expanded beyond the inguinal lymph node, it is difficult to cure. In this report, we present a case of multiple metastasized, receptor activator of nuclear factor kappa-B ligand-expressing EMPD in the pelvic lymph nodes successfully cured with continuous administration of bisphosphonate risedronate sodium after intensive CyberKnife radiotherapy and docetaxel monochemotherapy. Our present case suggested the usefulness of bisphosphonates as a maintenance therapy for metastatic invasive EMPD after the intensive chemoradiotherapy.

Hypopigmented mycosis fungoides (HMF) is a clinical variant of MF presenting a good prognosis. In this report, we describe a case of HMF with dense infiltration of tumor-infiltrating leukocytes that bear several cytotoxic molecules, such as granulysin and T-cell intracellular antigen-1. In addition, our immunohistochemical study revealed that the ratio of Foxp3+ regulatory T cells to the total CD4+ cells is decreased in the lesional skin of HMF, compared with that of conventional MF. Our case suggested possible mechanisms for the hypopigmentation and good prognosis of this type of MF.