Multimodal Therapy for Locally Advanced Scrotal Cancer: A Case Report With a Literature Review

TL;DR

A rare case of locally advanced scrotal cancer was treated with a combination of surgery and chemo-radiotherapy, showing a positive response.

Contribution

This case report presents a novel multimodal treatment approach for locally advanced scrotal SCC when traditional surgery is not feasible.

Findings

The patient's scrotal SCC was surgically excised with clear margins (T1 N3 M0 classification).

Concomitant chemo-radiotherapy was successfully used as an alternative to inguinal lymph node dissection.

The patient showed good clinical evolution four months after treatment initiation.

Abstract

Cancer of the scrotum is a rare tumor. It is often not diagnosed early, and its treatment poses difficulties for practicing oncologists. We report the case of a patient treated for locally advanced squamous cell carcinoma (SCC) of the scrotum, with a review of the literature. It's about a 66-year-old man, who had been complaining two years ago of an ulcerated lesion at the scrotal region neglected by the patient. However, he presented with a large ulceration on the left inguinal region, for which, the pathological study showed an SCC. CT scan found a left inguinal tumoral process invading the adjacent soft tissues and infiltrating the left spermatic cord without distant localizations. Surgical excision of the inguinal lesion was considered unfeasible, then, an excision of the scrotal lesion was done and the pathological study identified an SCC of the scrotum with clear margins classified T1 N3 M0. Given that inguinal lymph node dissection (LND) was not feasible, concomitant chemo-radiotherapy was indicated at a total dose of 70 Gy in 35 fractions of 2 Gy concomitantly with weekly platinum-based chemotherapy, with good evolution after four months.

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