Scrotal Basal Cell Carcinoma-A Rare Manifestation.

Case Presentation

A 68-year-old male presented with a 6-year history of a slowly growing ulcerated lesion on the scrotum. Dermatological examination revealed a polypoid lesion of 2 × 2 cm on an erythematous base on the left scrotum. The surface was ulcerated, and microbleeding spots were observed ( Figure 1, A and B). No other lesions were present. Contact dermoscopy of the lesion revealed polymorphic linearly grouped dotted vessels and short linear vessels. Surface ulceration was prominent with the rope sign. Crystallite structures were evident in the left lower quadrant. (Figure 1C). The patient was referred for total excision. The histopathology revealed basal cell cancer of metatypical type (Figure 1D). No new lesions were observed in the biannual follow-up visit.

Figure 1

(A and B) A 2 × 2 cm sized, polypoid, centrally ulcerated tumoral lesion on an erythematous base on the left scrotum. (C) Polymorphic linearly grouped dotted vessels and short linear vessels. Surface ulceration was prominent with the rope sign. (D) Widespread ulceration on the surface. Tumor cells proliferating as nodular structures from the basal layer to the stroma had pale large cytoplasm (H&E, × 100).

Teaching Point

Basal cell carcinoma is the most common type of cancer that is commonly seen on sun-exposed areas, yet it is rarely seen on the genitalia. Despite its rarity, genital basal cell carcinomas have increased risk of distant metastasis. Therefore, after the initial therapy, long-term follow-up is mandatory in these cases.