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Dermatology Online Journal

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Adenocarcinoma of the colon presenting with scrotal metastasis: case report and review of the literature


Background: The scrotum is an uncommon site for cutaneous metastases from visceral malignancies.Purpose: A man with colon cancer, which subsequently developed cutaneous metastasis to the scrotum is described.Materials and Methods: PubMed medical database was used to search the following terms separately and in combination: cutaneous metastasis, skin metastasis, scrotal metastasis, scrotum, rectal cancer, and colon cancer.Results: Cutaneous metastasis most frequently occur in the vicinity of the primary tumor. Skin sites of metastatic cancer may include the abdomen, back, chest, face, scalp, and genitalia. The reported patient developed metastatic cutaneous lesions of his colon cancer not only on the abdomen but also on the scrotum. Including our patient, 9 men have been described with metastatic colon or rectal carcinoma localized to the scrotum. The lesions were the presenting sign of malignancy in one man and in the others, the lesions appeared within 24 months of their initial diagnosis of cancer. The skin metastases were pleomorphic; they appeared as papules, nodules and/or cutaneous induration. Survival data was only reported in five of the patients.  However, colon or rectal metastases to the scrotum is a poor prognostic sign with a mean survival time of 11 months.Conclusion: Scrotal metastases from carcinoma of the colon or rectum may be the initial presentation of malignancy or herald the discovery of recurrent disease. The morphology of the metastatic tumor is variable: papules, nodules and/or sclerosis. The development of scrotal metastases from colon or rectal carcinoma portends a poor prognosis. Most of the patients succumb to theirmetastatic disease within a year.

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