Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(1):e2022004 1

Scrotal Basal Cell Carcinoma—A Rare 
Manifestation

Tugba Kevser Uzuncakmak1, Defne Özkoca1, Bengu Cobanoglu Simsek2, Server Serdaroğlu1

1 Istanbul University, Cerrahpasa, Cerrahpasa Medical Faculty Department of Dermatology, Istanbul, Turkey

2 Istanbul Medeniyet University Medical Faculty, Department of Pathology, Istanbul, Turkey

Citation: Uzuncakmak TK, Özkoca D, Simsek BC, Serdanoğlu S. Scrotal basal cell carcinoma – a rare manifestation. Dermatol Pract 
Concept. 2022;12(1):e2022004. DOI: https://doi.org/10.5826/dpc.1201a04

Accepted: April 13, 2021; Published: January 2022

Copyright: ©2022 Uzuncakmak et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication

Corresponding author: Tugba Kevser Uzuncakmak, MD, Istanbul University Cerrahpasa Medical Faculty, Department of Dermatology, 
Istanbul, Turkey. E-mail: drtugbakevser@gmail.com

Case Presentation

A 68-year-old male presented with a 6-year history of a 

slowly growing ulcerated lesion on the scrotum. Dermato-

logical examination revealed a polypoid lesion of 2 × 2 cm 

on an erythematous base on the left scrotum. The surface was 

ulcerated, and microbleeding spots were observed  (Figure 1, 

A and B). No other lesions were present. Contact dermos-

copy of the lesion revealed polymorphic linearly grouped 

dotted vessels and short linear vessels. Surface ulceration 

was prominent with the rope sign. Crystallite structures were 

evident in the left lower quadrant. (Figure 1C). The patient 

was referred for total excision. The histopathology revealed 

basal cell cancer of metatypical type (Figure 1D). No new 

lesions were observed in the biannual follow-up visit.

Teaching Point

Basal cell carcinoma is the most common type of cancer that 

is commonly seen on sun-exposed areas, yet it is rarely seen 

on the genitalia. Despite its rarity, genital basal cell carci-

nomas have increased risk of distant metastasis. Therefore, 

after the initial therapy, long-term follow-up is mandatory 

in these cases.



2 Image Letter | Dermatol Pract Concept. 2022;12(1):e2022004

References

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2. Dai B, Kong YY, Ye DW, Xu XW, Yao XD, Zhang SL. Basal cell 

carcinoma of the scrotum: clinicopathologic analysis of 10 cases. 

Dermatol Surg. 2012;38(5):783-790. DOI: 10.1111/j.1524-

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Figure 1. (A and B) A 2 × 2 cm sized, polypoid, centrally ulcerated tumoral lesion on an erythematous base on the left scrotum. (C) Poly-

morphic linearly grouped dotted vessels and short linear vessels. Surface ulceration was prominent with the rope sign. (D) Widespread 

ulceration on the surface. Tumor cells proliferating as nodular structures from the basal layer to the stroma had pale large cytoplasm 

(H&E, ×100).