Penis & scrotum
Inflammatory
Idiopathic scrotal calcinosis
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Last author update: 1 May 2010
Last staff update: 23 February 2023 (update in progress)
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Idiopathic calcinosis scrotum
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Clinical images | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Chaux A, Cubilla AL. Idiopathic scrotal calcinosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumidiopathiccalcinosis.html. Accessed April 2nd, 2023.
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
- Dystrophic calcification of epidermal cysts (Dermatol Online J 2010;16:5)
Clinical features
- Slow growing, painless masses and may extensively involve scrotum (Urology 2010;76:1493)
- Discharge of white chalky material
Clinical images
Contributed by Sleiman Khal, M.D.
Images hosted on other servers:
Various images
Case reports
- 50 year old man with scrotal nodules (Case of the Week #468)
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
Fig 3: H&E and calcium stain
Fig 4: Large deposits with multiple smaller deposits
Fig 6: Histiocytic giant cell
Fig 7: "Pseudocyst"
Fig 8: Calcium deposit
Figs 9 - 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
- Amorphous calcific masses and granules (J Cytol 2008;25:23)
Cytology images
Contributed by Sleiman Khal, M.D.
Images hosted on other servers:
FNA smear
Differential diagnosis
- Dystrophic calcification due to Onchocerca volvulus: presence of parasite in tissue sections
Board review style 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
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 style 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.
Comment Here
Reference: Idiopathic scrotal calcinosis
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.
Comment Here
Reference: Idiopathic scrotal calcinosis
