A case of pedunculated malignant melanoma of the scrotum.

We report a case of pedunculated malignant melanoma of the scrotum. A 48-year-old man noticed a pigmented macule on the scrotum 16 months previously. The lesion had enlarged and elevated gradually. When he visited our hospital on June 25, 2001, physical examination revealed an erosive, flesh-colored, 7.5cm in diameter, pedunculated tumor on the right side of his scrotum. In the broad neck of the tumor, black-colored macules were observed. Several right inguinal lymph nodes up to walnut-sized were palpable. Chest X-ray and computed tomography showed multiple pulmonary lesions. We diagnosed a malignant melanoma histologically, and performed a surgical resection with 3cm-margin and meshed split-thickness skin graft, right inguinal and external iliac lymph nodes dissection. UICC staging was IV (pT4bN2aM1b), and AJCC staging was IV (T4bN3M1b) . Multiple pulmonary metastases have enlarged and been increasing slowly, and yet the patient has been well during one year after initial diagnosis.Primary malignant mela a of the scrotum is a rare entity. Between 1949 and 2002, only 12 cases have been reported in the world. We review them and discuss the reason why melanoma of the scrotum is so infrequent. [Skin Cancer (Japan) 2002; 17: 177-181]