Fig. 4: Scrotal adenocarcinoma from an 80-year-old man (Table 1, case 9).

A Silhouette of a large nodulocystic tumor. B The tumor contains tubular structures surrounded by myoepithelial cells. C The tumor shows a lobular peripheral growth and does not involve the epidermis. D The tumor cells are positive for HPV42. The overlying epidermis is not.