A case of metastatic squamous cell scrotal cancer
The present case has been reported in the journal Annals of Emergency Medicine.

A 62-year-old man presented to the emergency department with concerns about fatigue, weight loss, and a self-described “boil” on his left lower abdomen. He stated that the lesion appeared and became rapidly progressive during the preceding 3 months.

Physical examination revealed a mildly wasted, elderly man with a 4-by-5-cm exophytic mass in the left inguinal fold and contralateral firm adenopathy. Subsequent complete genitourinary examination revealed a 6-by-3-cm exophytic mass on the posterior, left scrotal wall that was not offered in history by the patient.

CT revealed a mass extending from the wall of the scrotum. The left inguinal mass was a superficial extension from the adjacent lymph nodes. Urologic consultation recommended that the patient undergo partial scrotectomy and lymph node dissection. Ultimately, pathology confirmed the provisional diagnosis of metastatic squamous cell scrotal cancer.

Major takeaway:-
The chief concerns of weight loss and skin lesions should warn the emergency provider to fully undress the patient and adequately assess for gross adenopathy.

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