Tumors of the scrotal skin are rare. The most common benign lesion is a sebaceous cyst. Squamous cell carcinoma is the most common malignant tumor of the scrotum, although rare cases of melanoma, basal cell carcinoma, and Kaposi sarcoma have been reported. In the past, squamous cell carcinoma of the scrotum most commonly resulted from exposure to environmental carcinogens including chimney soot, tars, paraffin, and some petroleum products. Today, most cases result from poor hygiene and chronic inflammation.

Biopsy of the scrotal lesion must be performed to establish a histologic diagnosis. Wide excision with a 2-cm margin should be performed for malignant tumors. Surrounding subcutaneous tissue should be excised with the primary tumor; however, resection of the scrotal contents is rarely necessary. Primary closure using the redundant scrotal skin is usually possible. The management of inguinal nodes should be similar to that of penile cancer.

Prognosis correlates with the presence or absence of nodal involvement. In the presence of inguinal node metastasis, the 5-year survival rate is approximately 25%; there are virtually no survivors if iliac nodes are involved.

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