A Scrotal Rash Lasting Months in a Man With Genital Edema

Winston W. Tan, MD; Matthew S. Soberano, DO; A. Toledo, DO; Matthew Clarence Tan


June 23, 2022


Prostate cancer is the most common cancer among men and is the second leading cause of death. Although it is a slow-growing cancer, 34,500 of the 270,000 men diagnosed each year die.[1] An estimated 12.5% of men in the United States will develop prostate cancer during their lifetime. Age, hereditary factors, nutrition, and certain environmental factors are primary risks of developing prostate cancer.

Prostate cancer develops when cell division and cell death rates cease being equal. This leads to tumor growth that is uncontrolled. After the initial transformation, additional mutations affect various genes, including the genes for p53 and retinoblastoma; this can lead to progression of the tumor and metastasis. Most prostate cancers are adenocarcinomas.[2] Roughly 4% of cases have transitional cell morphology. These are believed to arise from the urothelial lining of the prostatic urethra. The rare cases that have neuroendocrine morphology are thought to arise from the neuroendocrine stem cells that are normally present in the prostate or from aberrant differentiation programs during cell transformation. Squamous cell carcinomas are rare, constituting less than 1% of all prostate carcinomas. In many cases, prostate carcinomas with squamous differentiation arise after radiation or hormone treatment.

Of prostate cancer cases, most arise in the peripheral zone (70%), 15%-20% arise in the central zone, and 10%-15% arise in the transitional zone. Most prostate cancers are multifocal, with synchronous involvement of multiple zones of the prostate, which may be due to clonal and nonclonal tumors.


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