Abstract
An 80-year-old white man presented with a 1-year history of recurrent eczema of the penis and right scrotum. The patient had first noticed an eczematous lesion in the right inguinal region. He had been treated for 1 year with topical corticosteroids and antibiotic ointments but the skin lesions had extended to the right scrotum and penis. Medical history was remarkable for 5 operations for right inguinal hernia. There was no history of other malignancy, gross hematuria or dysuria. Physical examination revealed a healthy elderly man without systemic symptoms (that is fever of unknown origin, marked weight loss or night sweats). The erythematous indurated ulcerated and crusted skin lesions involved the right inguinal region, proximal penis and right scrotum. Preoperative biopsy of the skin lesion demonstrated poorly differentiated extracutaneous adenocarcinoma. Ultrasound of the abdomen and chest x-ray were normal without signs of metastatic disease. Urethrocystoscopy revealed no pathological findings. Due to the age of the patient, further testing (for example computerized tomography) was not performed. The patient underwent wide excision of the skin lesion with a 3 cm. margin to the macroscopic normal tissue (fig. 1).
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