Squamous Cell Carcinoma Of The Penis And Scrotum

Faline · #1 ● 02-23-2012, 08:41 AM

Filarial genital lymphedema is a known entity involving the scrotum and the penis. Malignant changes which can arise in chronic lymphedema include Kaposi's sarcoma, melanoma, lymphoma, malignant fibrous histiocytoma, and squamous cell carcinoma.
The association with squamous cell carcinoma has been noted previously involving the upper limb and lower limb lymphedema, with additional factors for carcinogenesis. In this case we found no additional risk factors except for chronic lymphedema, suggesting that lymphedema itself may be a carcinogenic factor for squamous cell carcinoma.

Case:
A 45-year-old male with no significant medical history presented to us with ulcer on the scrotum and penis of 4-month duration. He had a history of surgery for lymphedema scrotum done 8 years back, probably postfilarial; details were not available except photograph. Considering this ulcer which was infected, debridement was done along with an excision biopsy of the ulcer. The biopsy report revealed squamous cell carcinoma of the scrotum and penis. Further a formal excision of the lymphedematous part of the scrotum and penis was done along with left orchidectomy and partial amputation of the penis with skin grafting of the penile shaft. The histopathological report of the same showed squamous cell carcinoma with marginal clearance. The wound has healed without any complication. The patient was referred to a medical oncologist for chemotherapy; at follow-up he clinically remains free from local recurrence and regional disease.

Lymphedema scrotum 8 years back:

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Ulcer over the scrotum and penis:

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Excision biopsy of the ulcer:

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Postoperative result after excision:

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Formal excision of the lymphedematous part of the scrotum and penis along with left orchidectomy and partial amputation of the penis with skin grafting of the penile shaft: