A rare case of metastatic extramammary Paget disease of the spine and review of the literature.

•Extramammary Paget disease is a rare intraepithelial neoplasm.•This patient presented with a symptomatic metastatic lesion to the L4 vertebral body.•Surgical decompression and stabilization was performed.•Metastatic spine disease should be carefully evaluated.•Surgery may improve neurologic function, pain, and quality of life.