Metastatic vulvar Paget's disease responding to combination chemotherapy: case report. No effective chemotherapy for advanced extramammary Paget's disease has yet been established. A case of vulvar Paget's disease with systemic metastases was treated with a mitomycin C, vincristine and cisplatin combination chemotherapy, by which the vulvar lesion and serum CEA were clearly decreased. After surgery and 5-fluorouracil treatment, a similar combination chemotherapeutic regimen was administered to treat a recurrence, however, the lesions became resistant.