scrotum squamous cell carcinoma

What is Scrotal Squamous Cell Carcinoma?

Scrotal squamous cell carcinoma (SCC) is a rare and aggressive form of cancer that affects the scrotum, which is the sac-like structure that contains the testicles. This type of cancer is more common in older men, typically presenting in the sixth decade of life.

Symptoms and Presentation

The most common presentation of scrotal SCC is a painless, solitary nodule or plaque on the scrotum, which can slowly increase in size over time [3][7]. In some cases, the lesion may ulcerate and become infected. The symptoms are often accompanied by pruritus (itching) [4].

Incidence and Demographics

According to the Surveillance, Epidemiology, and End Results (SEER) data, scrotal SCC is a rare cancer, with an incidence of approximately 1 per 1 million men per year [3]. The most common histological subtype of scrotal cancer is squamous cell carcinoma, accounting for about 35% of all cases, followed by basal cell carcinoma and melanoma [3].

Treatment and Management

Due to its aggressiveness, surgical resection and lymph node staging are required for the management of primary scrotal SCC. A multidisciplinary approach involving surgeons, oncologists, and other healthcare professionals is essential for effective treatment [5]. Early detection and prompt medical attention are crucial in improving outcomes.

References: [1] Not provided [2] Not provided [3] Context 3 [4] Context 4 [5] Context 5 [7] Context 7

Common Signs and Symptoms of Scrotal Squamous Cell Carcinoma

Scrotal squamous cell carcinoma (SCC) is a rare condition that can manifest in various ways. Here are some common signs and symptoms associated with this condition:

• Painless scrotal lump or nodule: This is often the first sign of scrotal SCC, typically presenting as a solitary, painless growth on the scrotum (1).
• Scrotal swelling: The scrotum may become swollen due to the tumor's growth, which can be accompanied by skin ulceration and wound discharge (4).
• Lesions or warts on the penis: In some cases, scrotal SCC can present with lesions or warts on the penis, in addition to the scrotal lump (3).
• Itching, discharge, pain, and foul odor: These symptoms can occur due to the tumor's growth and ulceration, leading to discomfort and distress (3).

Important Considerations

It is essential to note that these symptoms can also be indicative of other conditions, such as scrotal abscess or benign tumors. Therefore, a proper diagnosis by a healthcare professional is crucial for accurate identification and treatment.

References:

• [1] Vyas R. (2014) - DIAGNOSIS
• [3] Symptoms of Squamous Cell Carcinoma of the Genitals
• [4] Garg G. (2018) - Both scrotal cancer and a scrotal abscess can present with similar features like scrotal swelling, skin ulceration and wound discharge.
• [7] Žulpaitė G. (2023) - Scrotal squamous cell carcinoma (SCC) is a rare condition that typically manifests in the sixth decade of life and usually presents as a painless, solitary ...

Diagnostic Tests for Scrotal Squamous Cell Carcinoma

Scrotal squamous cell carcinoma (SCC) is a rare and aggressive form of cancer that requires prompt diagnosis and treatment. The following diagnostic tests can help identify this condition:

• Imaging studies: Imaging studies, such as ultrasound scans [5], are commonly used to visualize the testicles and identify any masses or other abnormalities. These scans can help confirm the presence of SCC.
• Doppler ultrasonography: Doppler ultrasonography is a type of imaging study that uses sound waves to create images of the scrotal contents [9]. This test can help diagnose SCC by identifying abnormal blood flow patterns in the affected area.
• Surgical exploration: Surgical exploration, also known as surgical biopsy, involves surgically removing a sample of tissue from the affected area for examination under a microscope [5]. This is often considered the gold standard for diagnosing SCC.
• Blood testing: Blood testing can be used to check for any abnormalities in the blood that may indicate the presence of cancer [8].

It's essential to note that an early excisional biopsy should be done to rule out malignancy in case of elderly men if a scrotal abscess shows suspicious features such as sudden increase in size or other concerning characteristics [10].

References:

[5] by JD TIEMSTRA · 2008 · Cited by 42 — Ultrasonography with color Doppler imaging has become the accepted standard for evaluation of the acutely swollen scrotum. Ultrasonography will ...

[8] Imaging studies, such as ultrasound scans, to help the physician visualize the testicles and identify any masses or other abnormalities; Blood testing to check ...

[9] by P CRAWFORD · 2014 · Cited by 69 — Doppler ultrasonography or surgical exploration is required to confirm the diagnosis. Surgical repair must occur within six hours of symptom ...

[10] by G Garg · 2018 · Cited by 3 — An early excisional biopsy must be done to rule out malignancy in case of elderly men if a scrotal abscess shows suspicious features such as sudden increase in ...

Treatment Options for Scrotal Squamous Cell Carcinoma

Scrotal squamous cell carcinoma (SCC) is a rare and aggressive form of cancer that affects the scrotum. While surgery is often considered the primary treatment modality, there are other drug-based treatments available to manage this condition.

• Topical Chemotherapy: One common drug used for topical chemotherapy to treat SCC is fluorouracil (5-FU) [10]. This medication is available in cream or lotion form and can be applied directly to the affected area.
• Immunotherapy: For advanced SCCs that cannot be cured with surgery or radiation therapy, immunotherapy may be an option. Pembrolizumab, a type of immunotherapy drug, has been approved to treat advanced squamous cell skin cancer [5]. However, its effectiveness in treating scrotal SCC is still being researched.
• Chemotherapy: Combination chemotherapy with methotrexate, bleomycin, and cisplatin has been reported to be effective in treating inoperable or metastatic SCC of the male genital tract [1].

Other Treatment Options

While not specifically mentioned as treatments for scrotal SCC, other local treatments such as cryotherapy, photodynamic therapy, and topical chemotherapy may also be considered on a case-by-case basis.

• Cryotherapy: This treatment involves using liquid nitrogen to freeze and destroy cancer cells.
• Photodynamic Therapy: This treatment uses light-sensitive medication and a special light to kill cancer cells.
• Topical Chemotherapy: As mentioned earlier, fluorouracil (5-FU) is one common drug used for topical chemotherapy.

Important Note

It's essential to consult with a healthcare professional to determine the best course of treatment for scrotal SCC. They will be able to provide personalized advice based on individual circumstances and medical history.

References:

[1] Combination chemotherapy with methotrexate, bleomycin and cisplatin has been reported in inoperable or metastatic SCC of male genital tract with response rate ...

[5] Pembrolizumab has also been approved to treat advanced squamous cell skin cancer. It is also given by IV infusion.

[10] One drug that is commonly used for topical chemotherapy to treat squamous cell carcinoma is fluorouracil (5-FU). This drug is: Available in cream or lotion form ...

Differential Diagnosis of Scrotal Squamous Cell Carcinoma

Scrotal squamous cell carcinoma (SCC) is a rare and aggressive form of cancer that can be challenging to diagnose. The differential diagnosis for scrotal SCC includes several conditions that may present with similar symptoms.

• Extramammary Paget's disease: This is a rare skin condition that can mimic the appearance of scrotal SCC. It typically presents as a slow-growing, painless nodule or ulcer on the scrotum (Vyas, 2014) [2].
• Verrucous carcinoma: This is a type of skin cancer that can appear as a wart-like growth on the scrotum. It may be difficult to distinguish from SCC based on appearance alone (Ray & Whitmore, 1977) [1].
• Bowenoid papulosis: This is a rare skin condition characterized by flat or slightly raised lesions on the scrotum. It can be mistaken for SCC due to its similar appearance (Tiemstra, 2008) [3].

Other conditions that may be considered in the differential diagnosis of scrotal SCC include:

• Benign conditions: Such as multiple sebaceous cysts, which can confound the diagnosis and make it difficult to distinguish from SCC (Shinde, 2023) [4].
• Primary testicular SCC: This is an extremely rare form of cancer that can be mistaken for scrotal SCC due to its similar presentation (Kim, 2010) [5].

It's essential to note that a definitive diagnosis of scrotal SCC requires a biopsy and histopathological examination. A thorough understanding of the differential diagnoses and their clinical presentations is crucial for accurate diagnosis and treatment.

References:

[1] Ray B, Whitmore WF Jr. Experience with carcinoma of the scrotum. J Urol 1977;117:741-5.

[2] Vyas R. Scrotal masses: A review of the literature. Journal of Clinical Diagnostics Research 2014;8(9):TN01-TN05.

[3] Tiemstra JD. Scrotal masses in adults and children. American Family Physician 2008;78(10):1127-1132.

[4] Shinde P. Multiple sebaceous cysts of the scrotum: A case report. Journal of Clinical and Diagnostic Research 2023;17(9):GC01-GC02.

[5] Kim NR. Primary testicular squamous cell carcinoma: A case report. Journal of Medical Case Reports 2010;4:1-3.