Scrotal Apocrine Adenocarcinoma with Pagetoid Phenomenonand Inguinal Lymph Node Metastases

We report a case of scrotal apocrine adenocarcinoma in a 72-year-old Caucasian male which was initially presented as areddish superficial lesion which in time became an ulcerated nodule. The initial pathological examination showed an apocrineadenocarcinoma with pagetoid phenomenon. The tumor recurred after four months and then excision biopsy showed tumor withpagetoid phenomenon which reached all the surgical margins. Three months later an ulcerated nodule in the scrotum and greatlyenlarged ipsilateral inguinal lymph nodes were noticed. The final pathological examination showed multiple separated malignantfoci, some with overlying pagetoid phenomenon and inguinal lymph node metastases. Immunohistochemistry showed positivityfor Gross Cystic Disease Fluid Protein-15 (GCDFP-15), androgen receptors, and score 3+ for the Human Epidermal growth factorReceptor-2 (HER2). The aggressive behavior of the present tumor goes along with previous reports showing that HER2 high scorecases exhibit a worse prognosis.