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PubMed1982

Basal cell carcinoma of the scrotum: a case report and literature review.

Basal cell carcinoma of the scrotum is a rarely occurring lesion that must be differentiated from the more common squamous cell carcinoma, as well as chronic dermatitis or chronic fungal infection. We report a case of basal cell carcinoma of the scrotum and review the literature. This case serves as a reminder that these lesions do occur on the scrotal skin and that, unlike squamous cell carcinomas, they are curable with simple wide excision.

Aged↗

PubMed1997

The acute scrotum.

Every boy with acute onset scrotal pain and swelling requires an immediate evaluation. Our protocol (Fig. 6) for the evaluation of these children is based on the history and physical examination combined with the selective use of imaging studies. When used appropriately, this protocol facilitates the rapid identification of children with torsion and minimizes the number of unnecessary scrotal explorations. When the duration of the pain is brief, and history and physical examination suggest that torsion is the most likely diagnosis, urgent surgical exploration without additional imaging studies is recommended. When it is not possible to definitely diagnose or exclude the diagnosis of testicular torsion, or when the duration of pain is greater than 12 hours, then diagnostic imaging can provide significant information. Color Doppler sonography is, in the authors' opinion, preferable to nuclear imaging for the evaluation of children with acute scrotums. When normal or increased blood flow is present, scrotal exploration is not required. When the study demonstrates decreased blood flow or does not provide a definite diagnosis, scrotal exploration is recommended. The authors recommend this approach because less than one third of these children have testicular torsion, and if routine scrotal exploration is performed for all boys with acute scrotums, a significant number of unnecessary surgical procedures will result.

Acute Disease↗

PubMed1997

Eccrine sweat gland carcinoma of the scrotum with associated extramammary Paget's disease.

Sweat gland carcinomas are rare tumors which have not previously been reported as arising from the scrotum. We present the first known case of primary eccrine sweat gland carcinoma of the scrotum in association with extramammary Paget's disease (EPD) and review the presentation and management of these tumors. Sweat gland carcinomas frequently coexist with EPD and this association provides insight into the histogenesis of EPD, which is presently unknown. Sweat gland carcinoma should be included in the differential diagnosis of cutaneous scrotal tumors and carefully ruled out pathologically if the diagnosis of EPD alone is made.

Adenocarcinoma↗

PubMed1988

Idiopathic calcinosis of the scrotum: histopathologic observations of fifty-one nodules.

A 29-year-old man had a 2-year history of multiple, asymptomatic, firm, subcutaneous nodules on the scrotal skin, which sometimes discharged a chalky material. Fifty-one nodules were observed in the histopathologic examination, which revealed, in addition to the typical findings of idiopathic calcinosis of the scrotum, various forms of intact cysts: epidermal (some calcified), pilar (calcified), hybrid (calcified), and indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected, with or without remnants of the cyst wall. These findings suggest that idiopathic calcinosis of the scrotum derives from the dystrophic calcification of cysts.

Adult↗

PubMed1996

Accessory scrotum or perineal collision-hamartoma. A case report to illustrate a misnomer.

A case of a congenital perineal tumor in a male infant is described, which consisted of separated fat and smooth muscle tissue in nodular arrangement. According to its clinical presentation, this lesion would be grouped into the category of so called "accessory scrotum," as part of the entity of ectopic scrotum. Based on our case and on a review of the literature, the possibility is raised that this labelling may be inappropriate on grounds of etiology and pathomorphology. It is suggested to consider similar lesions as the result of a perineal hamartomatous fat tissue overgrowth with transposed scrotal skin, which may or may not show additional hamartomatous proliferation of smooth muscle bundles, and to label them "perineal lipoma/lipoblastoma with ectopic scrotal skin" or "perineal collision-hamartoma" in the case of a prominent isolated smooth muscle component.

Hamartoma↗

PubMed1998

The acute paediatric scrotum: the role of colour doppler ultrasound.

Combined grey scale ultrasound and colour Doppler imaging of the acute paediatric scrotum provides a non-invasive means of assessing the structure and perfusion of the testis. Colour flow ultrasound is a sensitive and specific diagnostic tool for differentiating ischaemic pathology (in which blood flow rate is reduced) from inflammatory disease in which it is commonly increased. Using this technique the number of unnecessary surgical explorations of the scrotum can be reduced. The differential diagnosis of acute testicular pathology and the imaging characteristics of each disorder are described. Close collaboration between paediatric surgeons and radiologists is required to determine the optimal clinical and investigational strategy for each child.

Acute Disease↗

PubMed2001

The nontraumatic, acute scrotum.

Regardless of age, any presentation of an acute scrotum requires prompt triage and immediate evaluation. The potential for significant reduction in morbidity and mortality exists if timely diagnosis and treatment are provided. Often overlooked, an early scrotal examination in the emergency department may produce the most accurate information into the underlying pathologic process, be it systemic or localized to the scrotum. Although the immediately lethal conditions presenting as acute scrotal pain should be considered, the combined incidence and morbidity associated with testicular torsion make its exclusion paramount in acute scrotal presentations. Similarly, a painless scrotal mass must be assumed to be a testicular neoplasm until proven otherwise, with appropriate work-up and rapid urologic follow-up assured.

Acute Disease↗

PubMed1996

Irradiation of the scrotum: what some men need MOST: the Manual Orchid Shielding Technique.

Although the need for radiotherapy to the scrotum is now unusual, shielding for the contralateral testis is used to maintain fertility and to preserve the endocrine function of the testis. We report a simple radiotherapy technique to achieve this by manually removing the contralateral testis proximally from the scrotum, to the level of the inguinal ring, where it is held by the patient during radiotherapy. A lead shield placed over the hand, testis and penis reduces the dose to the testis to an acceptable < 1.5% of the tumour dose. This can be confirmed by thermoluminescent dosimetry.

Humans↗

PubMed2006

[Ultrasound of the scrotum].

Ultrasound is an excellent tool for the diagnosis of benign or malignant intra- and extratesticular lesions depending on their structure and location in the scrotum. Besides the sonographic appearance, the clinical history and the location of a scrotal mass is crucial for the differential diagnosis between benign and malignant masses. In cases of acute scrotum or of vascular and inflammatory lesions, Doppler ultrasound is mandatory. This article gives a systematical survey of the most frequent scrotal lesions and their appearance in ultrasound.

Abscess↗

PubMed1993

Carcinoma of the scrotum associated with rubber urinals. Case report.

A paraplegic patient, who had worn a rubber urinal in close contact with the scrotum for over 40 years, developed carcinoma of the scrotum. It is likely that this is a previously unsuspected example of chemical carcinogenesis, and in view of this, we believe that the use of rubber urinals should be discontinued.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery.

Infection is a devastating complication of penile prosthesis surgery that occurs in approximately 2-5% of all primary inflatable penile primary implants in most series. Prevention of hematoma and swelling with closed-suction drains has been shown not to increase infection rate and yield an earlier recovery time. Despite the intuitive advantages of short-term closed-suction drainage in reducing the incidence of postoperative scrotal swelling and associated adverse effects, many urologists are reluctant to drain the scrotum because of a theoretical risk of introducing an infection. In conclusion, this study was undertaken to evaluate the incidence of infection in three-piece penile prosthesis surgery with scrotal closed-suction drainage. A retrospective review of 425 consecutive primary three-piece penile prosthesis implantations was performed at three institutions in New Jersey, Ohio, and Arkansas from 1998 to 2002. Following the prosthesis insertion, 10 French Round Blake (Johnson & Johnson) or, in a few cases, 10 French Jackson Pratt, closed-suction drains were placed in each patient for less than 24 h. All subjects received standard perioperative antibiotic coverage. Average age at implant was 62 y (range 24-92 y). Operative time (incision to skin closure) was less than 60 min in the vast majority of cases. There were a total of 14 (3.3%) infections and three hematomas (0.7%) during an average 18-month follow-up period. In conclusion, this investigation revealed that closed-suction drainage of the scrotum for approximately 12-24 h following three-piece inflatable penile prosthesis surgery does not result in increased infection rate and is associated with a very low incidence of postoperative hematoma formation, swelling, and ecchymosis.

Adult↗

PubMed1999

Pigmented squamous cell carcinoma of the scrotum associated with a lentigo.

Only 13 cases of pigmented squamous cell carcinoma (SCC) have been reported in the English language literature, with most frequent development in the oral cavity and conjunctiva. However, no case of pigmented SCC of the scrotum has been reported. We report here a case of pigmented SCC that arose primarily in the scrotum of a 70-year-old man. Light microscopically, this tumour exhibited the typical features of a pigmented SCC, including not only keratinization and intercellular bridges but also colonization by plump dendritic melanocytes with marked pigmentation. These features were clearly confirmed by immunohistochemistry, including strong positivity of tumour cells for high-molecular-weight cytokeratin and of colonizing melanocytes for HMB-45. The tumour was associated with a lentiginous lesion and partly involved it. Melanocytes entrapped from the lentigo might therefore have been activated during enlargement of this tumour, resulting in melanocyte colonization. Fourteen cases of pigmented SCC, including ours, are clinicopathologically reviewed.

Aged↗

PubMed2003

Torsion of the epididymis: a rare cause of acute scrotum.

Acute scrotum is a common clinical problem and establishing its etiology can be difficult, often necessitating scrotal exploration. We report here a very rare case of acute scrotum: torsion of the epididymis. Only one such case has been reported previously in the literature.

Acute Disease↗

PubMedDate not supplied

Accessory scrotum: an unusual localization of scrotal skin.

Accessory scrotum is an extremely rare congenital scrotal anomaly defined as the occurrence of scrotal skin outside of its proper location with no testicular tissue. We report a preterm twin male infant who had an accessory scrotum located on the right inguinal and proximal femoral region.

Humans↗

PubMed2006

[Sonography of the scrotum].

Ultrasonography (US) has become the method of choice for imaging in diseases affecting the scrotum. With the development of high resolution transducers using colour Doppler and pulsed Doppler, it is now possible to make accurate diagnoses. Sonography is able to distinguish immediately between intra- and extratesticular lesions. It is also possible to differentiate between cystic and solid tumours. Solid testicular tumours may be detected without difficulty and thus the patient's dignity is practically assured (98 % of solid testicular tumours are malignant). In cases of acute diseases of the scrotum, sonography nearly always permits a differentiation between torsion and inflammation, thus avoiding the risk of unnecessary operations. The review covers the introduction, anatomy, the scanning protocol for scrotal ultrasound and pathological changes. Testicular tumours and torsion are discussed in detail. Variations from the norm and pitfalls are outlined so as to help avoid making misdiagnoses.

Diagnosis, Differential↗

PubMed1990

Accessory scrotum: report of a case.

Perineal ectopic (accessory) scrotum is an uncommon anomaly. We could trace only 5 such cases reported in the literature (8, 10, 11). A case of accessory scrotum and glandular hypospadias has been presented and discussed.

Humans↗

PubMedDate not supplied

Sonography of the acute scrotum: the four T's of testicular imaging.

The scrotum is frequently imaged on an emergent basis. The differential diagnosis of the acute scrotum can be divided into four categories-torsion, trauma, tumor, and "testiculitis" (epididymo-orchitis). Although testicular neoplasms are not imaged emergently, 15% are detected incidentally when performing an emergent scrotal ultrasound. Therefore, the emergent sonographic examination of the testicles should include a thorough search for malignancy. Images demonstrating the sonographic and color Doppler appearances of each of the "four T's" will be reviewed. The radiographic review will focus on the imaging features, which are the keys to arriving at the correct diagnosis.

Acute Disease↗

PubMed1987

The 'acute' scrotum. Lesions that require immediate attention.

An "acute" scrotum may result from an interesting and fairly predictable array of diseases. A good history and physical examination remain paramount in evaluation. Scrotal ultrasonography and testicular radionuclide scanning are important additions to our diagnostic armamentarium and should be used whenever possible. Unfortunately, the equipment and expertise needed to perform these useful examinations are not always readily available. If these tests cannot be done promptly and rapidly, treatment should be instituted without delay. Most lesions that cause an acute scrotum should be treated expeditiously, since careful treatment can greatly reduce patient discomfort, morbidity, and even mortality. Additionally, testicular salvage often depends on early and appropriate management.

Epididymitis↗