A 72-year-old man with history of itching for 8 months presented with an ill-defined, ulcerated, eczematous, thickened cutaneous lesion in the left perianal region. 18F-FDG PET/CT was performed, and neoplastic skin thickening with FDG uptake was seen at the left gluteal cleft. Hypermetabolic inguinal, retroperitoneal, and mediastinal lymph nodes, liver, and bone metastases were seen. Histopathology and immunohistochemistry of the perianal growth and left inguinal lymph node were positive for cytokeratin7 and gross cystic disease fluid protein and negative for cytokeratin 20 and CDX2, confirming the diagnosis of primary extramammary Paget disease with metastases.
High resolution ultrasound with color Doppler is the first-line imaging investigation in the evaluation of acute scrotum. It plays a crucial role in distinguishing urological emergencies necessitating immediate surgical exploration from those that can be managed conservatively. Acute scrotal pathologies can involve the scrotal sac or its contents like testis, epididymis and testicular appendages and could range from benign, self-limiting conditions to emergencies. In this pictorial essay, we briefly review the ultrasonographic technique, scrotal anatomy and characteristic imaging features of various pathologies presented as acute scrotum.
High resolution ultrasound with color Doppler is the first-line imaging investigation in the evaluation of acute scrotum. It plays a crucial role in distinguishing urological emergencies necessitating immediate surgical exploration from those that can be managed conservatively. Acute scrotal pathologies can involve the scrotal sac or its contents like testis, epididymis and testicular appendages and could range from benign, self-limiting conditions to emergencies. In this pictorial essay, we briefly review the ultrasonographic technique, scrotal anatomy and characteristic imaging features of various pathologies presented as acute scrotum.
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