Perianal Paget's disease (PPD) is a rare intraepithelial adenocarcinoma. The clinical appearance of PPD may be confused with dermatitis and fungal infections of the skin, resulting in delayed diagnosis, sometimes for years. It may also be associated with secondary malignancies. Surgery and non-surgical methods such as radiotherapy, immunomodulating drugs, and chemotherapy are used in the treatment of PPD. In this case report, two patients with PPD are presented; the first was treated with surgical excision and radiotherapy and the second did not accept surgical or medical therapy. Although the lesion deepened and expanded towards adjacent structures, no secondary malignancy or metastasis was observed. [ABSTRACT FROM AUTHOR]