Squamous-cell carcinoma of the scrotum

Squamous-cell carcinoma of the scrotum has a poor prognosis unless locally confined. Patients with stage A1 disease have approximately a 75% or better chance for long-term survival. Occupation-related and -induced scrotal carcinomas are less frequent now because of better hygiene, protective clothing, and awareness of the carcinogenicity of industrial oils. A rise in the incidence of the disease might result from the HPV epidemic. The basic treatment of squamous-cell carcinomas of the scrotum still depends on wide local excision of the primary lesion. Patients should be treated with a broad-spectrum antibiotic for 4 to 6 weeks prior to sentinel node biopsy or ilioinguinal lymphadenectomy. Sentinel node biopsy should be performed to rule out micrometastasis and to establish the need for a formal ilioinguinal lymphadenectomy. Radiation therapy has little therapeutic benefit in the management of squamous-cell carcinoma of the scrotum. Bleomycin might be useful as adjuvant therapy for widespread ilioinguinal disease before attempted resection, although this has yet to be proved.