title: Primary apocrine adenocarcinoma of scrotum suspected as urothelial carcinoma metastasis: A clinical and pathological dilemma.
abstract: A 78-year-old man presented with an enlarging, tender mass in the scrotum separate to the testes. This was on the background of radical cystoprostatectomy, urethrectomy, and ileal conduit formation for high-grade urothelial carcinoma of the bladder invading submucosa 3 years prior. Examination revealed a 4 × 5 cm lesion, which was hard, fixed to the overlying skin and nodular to palpation. Ultrasound confirmed a solid mass in the scrotum extending into the perineum. Computerized tomography of the chest, abdomen, and pelvis revealed enlargement of inguinal lymph nodes but no other metastases. Complete resection of the scrotal lesion and selective removal of regional lymph nodes was performed. Rather than a cutaneous scrotal metastasis from the bladder urothelial carcinoma, histological examination suggested a primary apocrine adenocarcinoma of the scrotum. This case report explores the clinical and pathological features associated with both of these unusual differential diagnoses.
authors: Department of Urology, Bairnsdale Regional Health Service, Alfred Health, Victoria, Australia ; Department of Urology, Alfred Health, Victoria, Australia.
authors: Sean
authors: S
authors: Huang
authors: Department of Urology, Bairnsdale Regional Health Service, Alfred Health, Victoria, Australia ; Department of Urology, Monash Health, Victoria, Australia.
authors: Mark
authors: M
authors: Frydenberg
authors: Department of Pathology, Alfred Health, Victoria, Australia.
authors: Alan
authors: A
authors: Pham
authors: Department of Urology, Bairnsdale Regional Health Service, Alfred Health, Victoria, Australia ; Department of Urology, Alfred Health, Victoria, Australia.
authors: Jeremy P
authors: JP
authors: Grummet
keywords: Adenocarcinoma; apocrine glands; case reports; scrotum; urologic neoplasms
references: Can J Urol. 2009 Oct;16(5):4860-2
references: 19796468
references: Urol Int. 1998;61(2):126-7
references: 9873256
references: Cancer. 1993 Jan 15;71(2):375-81
references: 7678545
references: Arch Dermatol. 1978 Feb;114(2):198-203
references: 629545
references: J Urol. 1981 Jan;125(1):36-9
references: 7463579
references: Arch Dermatol. 2007 Aug;143(8):1067-72
references: 17709671
references: Urology. 2004 Jun;63(6):1021-6
references: 15183939
references: Am J Surg Pathol. 2008 May;32(5):682-90
references: 18347508