Sir,
A 65-year-old Caucasian male presented with a 6×4×3 cm mass on the scrotal skin. The patient admitted that the lesion had been present for about ten years and it increased in size gradually. The past medical history was unremarkable. Physical examination revealed a hyperpigmented, erythematous, polypoid mass hanging from the left scrotal skin with a peduncle. The lesion was soft and nontender to palpation. In addition, there was a hyperkeratotic, skin colored, small papule on the left scrotum above the giant polypoid mass measuring 2×3×4 mm in size (
A hyperpigmented, erythematous, polypoid mass measuring 6×4×3 cm in size and a hyperkeratotic, skin colored, small papule on the left scrotal skin (white arrows).
a) A polypoid mass hanging from the left scrotal skin with a peduncle and a hyperkeratotic, small papule above the giant lesion (white arrows) b) The specimen after surgical excision.
A skin tag, also known as acrochordon or fibroepithelial polyp, is a common benign mesenchymal tumor. It usually presents as a small, pedunculated polyp in intertriginous areas such as neck, axilla, groin and face. Rarely, skin tags may appear in the respiratory tract, orophyarynx, female and male genitalia [
Giant skin tags are rare, and a few giant skin tag cases have been reported previously to the best of our knowledge. Ghosh et al. reported four cases with giant skin tags on unusual localizations including nipple (3×2.5 cm), eyelid (0.5×2 cm) and right thigh (2.5×2.5 cm) [
The diagnosis of a skin tag is usually made by its clinical features [
In conclusion, giant skin tags have been reported on labium majus, penis and perineum previously. However, a 6×4×3 cm giant skin tag on the scrotal skin is the first case report in the English medical literature to the best of our knowledge. Moreover, the patient had both a giant skin tag and verruca anogenitalis on the scrotal skin. These findings support that HPV infection may play role in the etiology of skin tags.