Scrotal calcinosis, dystrophic or idiopathic, does it matter? A case report

@#Scrotal calcinosis is a rare condition with controversy surrounding its unclear etiopathogenesis. Several schools of thought have emerged from recent publications supported by histological findings seen in the respective cases reported. The recommendation of surgery as management, and its outcome, however, have remained the same throughout history. This paper reports a 36-year-old male who presented with gradually progressing multiple pruritic nodules over the scrotum who underwent wide excision with favorable outcome on follow up. Histological examination confirmed the diagnosis of scrotal calcinosis and showed evidence of intact epidermoid cysts that have undergone dystrophic calcification.

A Case of Scrotal Calcinosis Originating from a Milium-like Syringoma / 대한피부과학회지

Scrotal calcinosis is a relatively common tumor of the male genitalia but there is controversy in the literature regarding its pathogenesis. The authors of many case reports debate whether the lesions are truly idiopathic or if they arise from other conditions. Only few cases of scrotal calcinosis have been proven to have an eccrine origin so far. Herein, we report a case of scrotal calcinosis originating from a milium-like syringoma in a male Korean patient.

Clinical Experience of Polypoid Idiopathic Scrotal Calcinosis

Idiopathic scrotal calcinosis is rare entity, characterized by the presence of multiple, firm nodules within the dermis of scrotal skin. The lesions are evident as asymptomatic, round, firm, yellowish papules, from several millimeters up to 1 cm in diameter, with a tendency to occur symmetrically. Because polypoid formation of the calcified cysts is unusual in scrotal calcinosis, we report our experience of a case of scrotal calcinosis with cysts having polypoid appearence. A 34-year-old man was admitted to our department with painless, firm, widespread nodules within the scrotum. Patient started to have these lesions at puberty and progressed to a polypoid form over time. There was neither surgical nor medical treatment had been attempted before our treatment. Physical examination revealed localized polypoid cysts in addition to multiple small, firm nodules within the scrotal skin. No underlying anomalies were detected in the physical examination and laboratory analysis. We experienced the treatment of polypoid idiopathic scrotal calcinosis and a case is presented with the review of literatures.

A Case of Scrotal Calcinosis Associated with Pilar Cyst / 대한피부과학회지

Idiopathic calcinosis of the scrotum appears in childhood as multiple, asymptomatic nodules of the scrotal skin that gradually increase in size and number and sometimes discharge a chalky material. Histopathologic examination shows calcific deposits of various sizes that are present in the dermis and often surrounded by foreign body granulomatous inflammation. The pathologic mechanism of this condition is not clear, but there is accumulating evidence for dystrophic calcification of cyst rather than an idiopathic genesis. Here we present a 34-year-old otherwise healthy man who had a 10-year history of multiple, asymptomatic, firm, subcutaneous nodules of the scrotal skin, which sometimes discharged a chalky material. The nodules were completely excised and 45 nodules were observed in the histopathologic examination. In addition to the typical findings of idiopathic calcinosis of the scrotum, seven intact cysts were observed among 45 nodules. Among the seven cysts there were five pilar cysts and two indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected. These findings suggest that idiopathic calcinosis of the scrotum may be deriven from the dystrophic calcification of cysts.

A Case of Scrotal Calcinosis Originated from Trichilemmal Cyst / 대한피부과학회지

We experienced a case of scrotal calcinosis which was considered to be developed from the trichilemmal cysts of the scrotum. This 22 year-old male patient has been suffered from pea-sized hard muliple yellowish nodules of the scrotum since. about 5 years ago. Histopathologic findings revealed multiple cysts or calcium lumps surrounded by variable a.mounts of granulomatous inflammatory infiltrations in the dermis. The cysts were lined by stratified squamous epithelium without intercellular bridge and surrounded by scanty inflammatory cells. Several cysts contained homogenous keratinous material but most cysts contained calcium deposits within the homogenous keratinous materials or only the calcium lumps in the intact epithelial linings. Most of calcium lumps which had partially or completely disintegrated epithelial linings were surrounded by active granulomatous inflammatory infiltrations and a few calrium lumps with completely disintegrated epithelial linings had no surrounding inflammatory cells. Observing the above histopathologic features, we could consider that this case of scrotal calcinosis was developed from the scrotal trichilemmal cyst and some cases of idiopathic scrotal calcinosis, previousely reported, were the end stage of the above process.

A Case of Scrotal Calcinosis Associated with Epidermal Cysts / 대한피부과학회지

Scrotal calcinosis, consisting of solitary or multiple circumscribed calcium deposits within the dermis of the scrotum, is generally assumed to be one the idiopathic type of calcinosis. We present herein a case of serotal calcinosis associated with scrotal epidermal cysts in a 29-year-old male patient who had multiple, 2 to 6mm sized, yellowish or flesh colored nodules in the dermis, Histopathologically multiple ncdules showed intact epidermal cyzts, an epidermal cyst with a partialIy degenerated wall and surrounding foreign body reaction, and calcium deposits with foreign body reaction in the dermis without an epithelial lining around calcium deposit. Therefore, idiopathic scrotal calcinosis may repreeent the end stage of dystrophic calcificati.on associated with inflammation of the scrotal epidermal cysts.