David Samadi, MD - Blog | Prostate Health, Prostate Cancer & Generic Health Articles by Dr. David Samadi - SamadiMD.com|

View Original

Paget's Disease of the Scrotum

The 19th century surgeon and pathologist Sir James Paget has a number of diseases which bear his name. The most well-known ailment in the Paget's family, called simply “Paget's Disease,” concerns your bones. The one that is of particular concern to men is Paget's Disease of the Scrotum. Symptoms may include:

  • Lesion on the skin of scrotal sac
  • Inflamed-appearing rash which may itch and burn
  • Eczema-like appearance of the lesion
  • Ulceration of the lesion
  • Bleeding, which may lead to bacterial and fungal infections
  • Increased sensitivity in the scrotal region
  • Pain, especially during intercourse

Paget's Disease of the Scrotum is a rare disorder, and one that is more likely to strike older (mean age is 71 years) men. The causes of the disease remain a mystery, but doctors have begun to hazard some guesses. Prominent among the speculation is a genetic mutation.

If you suspect you may be suffering from Paget's, see your physician. After assessing your medical history and performing a physical examination, he will likely schedule some imaging, which could include ultrasound, computerized tomography, and magnetic resonance imaging. If he sees something he doesn't like, he will likely have a scrotum tissue biopsy performed.

Once diagnosed, the best course of action is most often surgery. Usually a wide surgical incision is made in the scrotum and the entire tumor is removed (unless it has metastasized, often to the lymph nodes of the groin).

Other surgical procedures adopted versus Paget's Disease of the Scrotum include a partial removal of the scrotum, known as a “scrotal reduction.” More extreme cases may warrant a complete removal of the scrotum, sometimes with the local lymph nodes – a procedure known as bilateral inguinal and femoral lymphadenectomy. If the tumor is particularly large, your doctor may have no choice bu to perform a partial pelvic exenteration. In this procedure, all the cancer tissue and surrounding pelvic tissue is excised to reduce the mass of the tumor. Radiation therapy and chemotherapy usually follow. Less severe cases may be treated non-surgically; methods include radiotherapy, chemotherapy, laser therapy (using CO2), and photodynamic therapy.

The prognosis for men who discover and treat their Scrotal Paget's early is good. The best tactic is prevention, of course, and although doctors do not know the disease's precise cause, they agree that men can prevent or delay the disease's onset by eating a healthy diet, limiting tobacco and alcohol, and staying active.