Given that aminobisphosphonate has been reported to decrease pro-MMP-9 and may abrogate the induction of CD163+ M2 macrophages in the tumor microenvironment, bisphosphonates might be effective for the prevention of not only bone metastasis but also disease progression in patients with invasive EMPD [68,69]. Here, MMP9 is linked to extramammary Paget disease.