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      Scrotal calcinosis: two case reports

      case-report

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          Abstract

          Background

          Scrotal calcinosis is a rare and benign condition. It usually gives rise to few symptoms, and the impact is mainly functional and aesthetic. It is considered part of dystrophic calcinosis cutis. Surgical management is the only curative approach, and recurrence has been described in few cases.

          Case presentation

          We report cases of two North African white patients with operated scrotal calcinosis. We describe the clinical and histological aspects as well as a pathogenic hypothesis and surgical management principles.

          Conclusions

          A surgical approach to scrotal calcinosis must consider the aesthetic and functional aspects postoperatively. A complete excision prevents recurrence. Psychological support is required in association with surgery because the lesions are benign and concern an intimate part of the body.

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          Most cited references12

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          Idiopathic calcinosis of the scrotum: histopathologic observations of fifty-one nodules.

          David Song, W. Kang, De-Hyung Lee (1988)
          A 29-year-old man had a 2-year history of multiple, asymptomatic, firm, subcutaneous nodules on the scrotal skin, which sometimes discharged a chalky material. Fifty-one nodules were observed in the histopathologic examination, which revealed, in addition to the typical findings of idiopathic calcinosis of the scrotum, various forms of intact cysts: epidermal (some calcified), pilar (calcified), hybrid (calcified), and indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected, with or without remnants of the cyst wall. These findings suggest that idiopathic calcinosis of the scrotum derives from the dystrophic calcification of cysts.
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            Lymphangiome der Haut mit verkalktem Inhalt

            Lewinski, H.M. Lewinski, HM Lewinski (1883)
            Article 0 comments Cited 8 times – based on 0 reviews     Review now
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              Scrotal calcinosis: idiopathic or dystrophic?

              Veena Maheshwari, Suparna Dubey, Rajeev Sharma (2009)
              Scrotal calcinosis is a rare benign local process characterized by multiple, painless, hard scrotal nodules in the absence of any systemic metabolic disorder. Histological examination reveals extensive deposition of calcium in the dermis, which may be surrounded by histiocytes and an inflammatory giant cell reaction. Numerous theories have been propounded to explain the pathogenesis of this condition, but the principal debate revolves around whether the calcium is deposited at the site of previous epithelial cysts or the calcified nodules are purely idiopathic. This is the largest study of scrotal calcinosis to date with 100 cases, on which clinical, biochemical, radiological, cytopathological, and histopathological examinations were conducted. The histological picture shows a continuous spectrum of changes ranging from intact epithelial cysts (41.0%) - both normal and inflamed; through inflamed cysts containing calcific material in the lumen but with intact cyst wall (53.0%); calcified inflamed cysts with partial epithelial lining (11.0%); to 'naked' calcium deposits lying in the dermis (100%), sometimes compressing surrounding collagen fibres to form a pseudocyst (56.0%). The presence of normal values of calcium and phosphorus along with this spectrum of changes in histology both support the theory that these form by dystrophic calcification of epithelial cysts in a progression that involves inflammation, rupture, calcification and obliteration of the cyst wall.
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                Author and article information

                Contributors
                O. Karray: omar.karray.88@gmail.com
                A. Dhaoui: amendhaoui@gmail.com
                R. Boulma: rami_boulma@yahoo.fr
                K. Bellil: kadija.bellil@rns.tn
                H. Khouni: hass_elkhouni@gmail.com
                Journal
                Journal ID (nlm-ta): J Med Case Rep
                Journal ID (iso-abbrev): J Med Case Rep
                Title: Journal of Medical Case Reports
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1752-1947
                Publication date (Electronic): 5 November 2017
                Publication date PMC-release: 5 November 2017
                Publication date Collection: 2017
                Volume: 11
                Electronic Location Identifier: 312
                Affiliations
                [1 ]Urology Unit, Inrerior security forces hospital, La Marsa, Tunisia
                [2 ]Pathology Department, Inrerior security forces hospital, La Marsa, Tunisia
                Article
                Publisher ID: 1451
                DOI: 10.1186/s13256-017-1451-8
                PMC ID: 5671649
                PubMed ID: 29101926
                SO-VID: 4b3d8aba-7762-497d-a5e1-06cc4f179c4a
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 10 August 2017
                Date accepted : 12 September 2017
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Medicine
                Keywords: scrotum,calcinosis,surgery
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: scrotum, calcinosis, surgery

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