A 30-year-old white man presented with a 3-month history of scrotal lesions. His scrotum was moderately sore and "felt heavy."
His medical history was remarkable for colorectal carcinoma, which had been diagnosed 2 years prior to presentation. He had been treated surgically with placement of a colostomy after radiation therapy and fluorouracil and leucovorin calcium therapy. A workup for metastatic disease included a computed tomographic scan of the chest that revealed numerous small (<1-cm) nodules scattered throughout the lungs, consistent with pulmonary metastases. A computed tomographic scan of the abdomen and pelvis revealed no abnormalities other than some presacral soft tissue thickening, which was attributable to his surgery. His social history revealed that he had not been sexually active for 2 years. His family history was negative for colon carcinoma.
Boucher KW, Heymann WR. Ulcerated Papules of the Scrotum. Arch Dermatol. 2001;137(4):495-500. doi: