Scrotum Ulcer Developed After Intraperitoneal Hyperthermic Chemotherapy with Mitomycin-C

Scrotal Necrosis Following Heated Intra-peritoneal Chemotherapy: Case Report and Review of the Literature

“…It manifests as the pain of the genitalia with apparent tissue devitalization during the post-operative phase. This is postulated to occur due to the underlying anatomy of patent processus vaginalis (PPV), which allows the chemotherapeutic agent to travel into the intra-scrotal region from the peritoneal cavity [ 9 , 10 ]. When this occurs intra-operatively, the scrotum cannot be evacuated simultaneously with the peritoneal cavity, leading to extended contact with MMC.…”

“…Other authors have documented minimal to partial improvement of symptoms with systemic antibiotics [ 9 , 13 ]. Fabiana et al also reported partial improvement with topical scavenger agent dimethyl sulfoxide [ 10 ]. While this approach was deemed inadequate, Baron et al highlighted the significance of early conservative measures to prevent premature operative management [ 13 ].…”

“…Some authors have suggested screening for PPV with pre-operative imaging or intra-operative identification to prevent this complication [ 10 , 11 ]. The underlying anatomy of PPV has been extensively studied in the context of peritoneal dialysis patients presenting with scrotal edema and post-prostatectomy patients presenting with inguinal hernia [ 14 , 15 ].…”