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World J Clin Cases. Nov 16, 2014; 2(11): 654-660
Published online Nov 16, 2014. doi: 10.12998/wjcc.v2.i11.654
Squamous cell carcinoma of the scrotum: A look beyond the chimneystacks
Ritva Vyas, Homayoun Zargar, Rossella Di Trolio, Giuseppe Di Lorenzo, Riccardo Autorino
Ritva Vyas, Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH 44106, United States
Homayoun Zargar, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OU 44195, United States
Rossella Di Trolio, Unit of Medical Oncology and Innovative Therapy, National Cancer Institute “Fondazione Giovanni Pascale”, 80100 Napoli, Italy
Giuseppe Di Lorenzo, Genitourinary Cancer Section and Rare-Cancer Center, Medical Oncology Division, University Federico II, 80100 Napoli, Italy
Riccardo Autorino, Urology Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, United States
Riccardo Autorino, Urology Unit, Second University of Naples, 80100 Naples, Italy
Author contributions: All authors contributed to this paper.
Correspondence to: Riccardo Autorino, MD, PhD, FEBU, Urology Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States. ricautor@gmail.com
Telephone: +1-440-5168700 Fax: +1-216-2015276
Received: June 11, 2014
Revised: August 23, 2014
Accepted: September 16, 2014
Published online: November 16, 2014
Processing time: 152 Days and 9.2 Hours
Abstract

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.

Keywords: Squamous cell carcinoma; Genital cancer; Scrotal cancer

Core tip: Scrotal squamous cell carcinoma (SCC) although rare, represents one of the most common forms of scrotal malignancy. The epidemiology of SCC has changed over time and iatrogenic conditions (psoralens and ultraviolet A radiation, immunosuppression, etc.) and human papilloma virus infection play a significant role as associated conditions. Surgery is the cornerstone of treatment and primary excision with a risk stratified approach for staging and treatment of regional lymph node is advisable. Sentinel lymph node biopsy can mitigate the morbidities of unwarranted inguinal lymph node dissection in selected cases. For locally advanced and metastatic disease palliative chemotherapy is advocated. Targeted therapies might hold promise for management of advanced SCC.