Psoriasis: association with 2 rare cutaneous urological malignancies

Squamous cell carcinoma of the scrotum: A look beyond the chimneystacks

Despite the low incidence, squamous cell carcinoma (SCC) remains the most common scrotal malignancy with a propensity for recurrence and metastasis. In recent years there has been a significant change in the epidemiology of scrotal SCC. Surgery is the mainstay of treatment for resectable disease. Sentinel lymph node dissection adapted from experience with penile SCC can reduce the morbidity of routine lymph node dissection. Emerging treatments for advanced and metastatic SCC are at the cusp of significantly changing management of this disease. We have performed a comprehensive review of scrotal SCC with a focus on these topics.

New insights into the aetiology of scrotal cancer, a nationwide case-control study in the Netherlands

BACKGROUND

Although scrotal cancer is traditionally regarded as an occupational disease, there is increasing evidence that factors which are involved in cutaneous and genital carcinogenesis might play a role in the carcinogenesis of scrotal cancer.

OBJECTIVE

This exploratory study aimed to detect exposures that might have an aetiological relation with scrotal cancer.

METHODS

A nationwide population-based case-control study was conducted in the Netherlands. The patients were identified through the Netherlands cancer registry. Controls were recruited among acquaintances of the cancer registry registrars. The participants completed a questionnaire that included questions on occupational exposures, naked sunbathing, use of sunbeds, skin diseases and their treatments, treatments for cancer and sexually transmitted diseases. Age-adjusted odds-ratios (ORs) were calculated.

RESULTS

Forty-seven scrotal cancer patients and 125 controls completed the questionnaire. The patients were categorized according to histology of the scrotal tumours. Having had a skin disease (OR = 6.3, 95% CI = 1.8-22), especially psoriasis (OR = 8.7), increased the risk of squamous cell carcinomas (SCC) of the scrotum. A previous cancer diagnosis may affect the risk of scrotal basal cell carcinomas (BCC; OR = 4.9, 95% CI = 0.9-27.3). Furthermore, an association between the number of sexual partners and the occurrence of scrotal sarcoma was found.

CONCLUSION

Scrotal SCCs may be related with skin diseases or skin disease treatments. Having had cancer may be a risk factor for a BCC of the scrotum. Scrotal sarcomas seem to be correlated with the number of sexual partners. This study suggests that scrotal cancer has characteristics of both cutaneous and genital carcinogenesis.

Verrucous scrotal carcinoma in a patient with hypospadias: is there a possible association?

We report a case of a locally advanced verrucous scrotal cancer in a patient with hypospadias. Surgical excision was performed and no recurrence was noted with 14 months of follow-up. To our knowledge, this association has not been reported. Historically, scrotal carcinoma is occupation related, but none of the occupational predisposing factors was identified in this patient. This observation suggests that hypospadias and secondary chronic inflammation of the scrotal skin, caused by prolonged contact with urine, may contribute to an increased risk of verrucous carcinoma.