Penis and scrotum
Nonneoplastic lesions of scrotum
Idiopathic calcinosis


Topic Completed: 1 May 2010

Revised: 14 February 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Idiopathic calcinosis scrotum

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
Page views in 2018: 3,197
Page views in 2019 to date: 3,672
Cite this page: Chaux A, Cubilla AL. Idiopathic calcinosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumidiopathiccalcinosis.html. Accessed July 23rd, 2019.
Definition / general
  • Uncommon disorder characterized by presence of calcified nodules in scrotal skin
Epidemiology
  • 2/3 patients are young adults
  • Lesions appear first in childhood or early adulthood
Etiology
Clinical features
  • Slow growing, painless masses and may extensively involve scrotum (Urology 2010;76:1493)
  • Discharge of white chalky material
Clinical images

Contributed by Dr. Sleiman Khal


Images hosted on other servers:

Various images

Case reports
Gross description
  • Size varies from a few millimeters to several centimeters
  • Nodular, bosselated masses
Microscopic (histologic) description
  • Granules and globules of basophilic calcified material in scrotal dermis
  • Foreign body giant cell reaction is common
  • Remnants of epidermal cysts seen in some cases
Microscopic (histologic) images

Contributed by Debra Zynger, M.D.



Images hosted on other servers:

Foreign body giant cell reaction

Calcification in scrotal soft tissue

Fig 3: H&E and calcium stain

Fig 4: Large deposits with multiple smaller deposits

Fig 5: Foreign body giant cell reaction

Fig 6: Histiocytic giant cell


Fig 7: "Pseudocyst"

Figs 8 - 10: Calcium deposit completely lined by true cyst wall

Figs 11 - 12: Calcium deposit partially lined by true cyst wall


Fig 13: Epithelial cysts of varying shapes / sizes

Fig 14: Hair follicle abnormalities

Cytology description
Cytology images

Contributed by Dr. Sleiman Khal



Images hosted on other servers:

FNA smear

Differential diagnosis
  • Dystrophic calcification due to Onchocerca volvulus: presence of parasite in tissue sections
Board review question #1
Which of the following is true about scrotal calcinosis?

A. May occur in the setting of a pre-existing epidermoid or pilar cyst, or by apparent calcification of dermal tissue without an identifiable cyst precursor
B. Is always associated with a detectable pre-existing cyst
C. Patients usually have metabolic abnormalities and evidence of systemic calcification
D. Typically presents in older men
Board review answer #1
A. Scrotal calcinosis may occur in the setting of a pre-existing epidermoid or pilar cyst or by apparent calcification of dermal tissue without an identifiable cyst precursor.

Approximately 70% of scrotal calcinosis cases are associated with a pre-existing epidermoid or pilar cyst. They may also occur via calcification of dermal connective tissue in the apparent absence of detectable cyst epithelium (idiopathic), possibly related to eccrine duct milia or degenerated dartos muscle.

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