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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2011  |  Volume : 22  |  Issue : 2  |  Page : 357-358
Gigantic scrotal calcinosis

1 Department of Surgery, F.S.I Hospital La Marsa, La Marsa, Tunisia
2 Department of Anesthesiology-Reanimation, F.S.I Hospital La Marsa, La Marsa, Tunisia
3 Department of Radiology, F.S.I Hospital La Marsa, La Marsa, Tunisia

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Date of Web Publication18-Mar-2011

How to cite this article:
Khouni H, Bouchiba N, Amara Y, Sbabti R, Charfi M, Elkateb F, Chouchene A, Benchikh M, Balti MH, Bouhaoula H. Gigantic scrotal calcinosis. Saudi J Kidney Dis Transpl 2011;22:357-8

How to cite this URL:
Khouni H, Bouchiba N, Amara Y, Sbabti R, Charfi M, Elkateb F, Chouchene A, Benchikh M, Balti MH, Bouhaoula H. Gigantic scrotal calcinosis. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2022 Jun 27];22:357-8. Available from: https://www.sjkdt.org/text.asp?2011/22/2/357/77643
To the Editor,

Idiopathic scrotal calcinosis is a rare benign entity that consists of multiple calcified nodules within the scrotal skin; nodules may range from one to a hundred in number and from 1 mm to several centimeters in size. We encountered a 48-year-old man with a 4-month history of a­symptomatic scrotal tumors, which had gradually increased in size and number; sometimes they degenerated to discharge a chalky material. Phy­sical examination revealed bilateral multiple ye­llowish papules within scrotal skin, and with a diameter of 12-15 cm [Figure 1] and [Figure 2]. The patient had no history of trauma, inflammatory disease or metabolic disorder, and no family history of similar or other skin lesions. He had a normal urinalysis and blood chemical examina­tion which included calcium, phosphorus and parathyroid hormone.
Figure 1: Bilateral multiple subcutaneous papules of scrotal skin.

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Figure 2: Bilateral multiple subcutaneous papules of scrotal skin.

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The tumors were removed under general anes­thesia, and on histological examination, the no­dules were composed of basophilic calcified ma­terial and located in the dermis, while foreign giant cells and fibrosis were present adjacent to the atrophic stratified squamous epithelium [Figure 3]. Immunhistochemically, carcinoembryo­nic antigen (CEA) was negative while cytoker­tin was positive on the surface of the epithelial lining of the scrotum. No recurrence was ob­served after a 9-month follow-up period, and a good esthetic result was obtained.
Figure 3: Macroscopic aspect after surgical removal.

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Idiopathic calcinosis of the scrotum is a rare condition that is characterized by the presence of multiple calcified and asymptomatic nodules within scrotal skin, ranging in size from a few millimeters to several centimeters. [1],[2] It may occur in patients of age from 9 to 85 years. [3] The nodules are usually confined to the scrotum and are mostly asymptomatic. [4] However, a feeling of heaviness in the scrotum, discharge and itching are the most frequently encountered com­plaints. [5] A case of scrotal calcinosis mimicking a chronic pelvic syndrome was also reported. [6] The pathogenesis of this condition is still not clear, which could be dystrophic calcification of cysts, [7] inflammation and calcification, [8] or benign eccrine epithelial cyst, [9] or an idiopathic entity. [2],[10] Scrotal calcinosis can only be differentiated by histological examination from testicular tumors, gonadoblastomas and Leydig cell tumors. [11] Sub­total excision of the scrotal wall seems to be the gold standard for the treatment of this condi­tion, mainly for large tumors. [4] Finally, there is a novel pinch-punch excision for small scrotal calcinosis with a good surgical outcome. [12] In the case presented here, there was a gigantic tumor which was completely excised, with a satisfactory result during the period of follow­up.

   References Top

1.el Fassi MJ, el Ammari JE, Khallouk A, Achour Y, Tazi MF, Farih MH. Scrotal calcinosis. Prog Urol 2003;13(2):332-3.  Back to cited text no. 1
2.Wright S, Navsaria H, Leigh IM. Idiopathic scrotal calcinosis is idiopathic. J Am Acad Dermatol 1991;24:727-30.  Back to cited text no. 2
3.Saad AG, Zaatari GS. Scrotal calcinosis: is it idiopathic? Urology 2001;57:365.  Back to cited text no. 3
4.Ruiz-Genao DP, Rios-Buceta L, Herrero L, Fraga J, Aragues M, Garciadiez A. Massive scrotal calconosis. Dermatol Surg 2002;28:745­-7.  Back to cited text no. 4
5.El Moutaoui L, Chiheb S, Azouzi S, Benchikhi H. Idiopathic scrotal calcinosis. Ann Dermatol Venereol 2007;134:707-8.  Back to cited text no. 5
6.Tsai YS, Tzai TS, Lin JS, Tong YC. Scrotal calcinosis presenting with prostatitis-like symp­toms. Urology 2002;59:138.  Back to cited text no. 6
7.Song DH, Lee KH, Kang WH. Idiopathic calci­nosis of the scrotum: histopathologic observa­tions of fifty-one nodules. J Am Acad Dermatol 1988;19:1095-101.  Back to cited text no. 7
8.Swinehart JM, Golitz LE. Dystrophic calcifica­tion of epidermoid cysts. Arch Dermatol 1982; 118:985-8.  Back to cited text no. 8
9.Ito A, Sakamoto F, Ito M. Dystrophic scrotal calcinosis originating from benign eccrine epithelial cysts. Br J Dermatol 2001;144:146-50.  Back to cited text no. 9
10.Hicheri J, Badri T, Fazaa B, et al. Scrotal calci­nosis: Pathogenesis and case report. Acta Der­matovenerol Alp Panonica Adriat 2005;14(2): 53-6.  Back to cited text no. 10
11.Parlakgumus A, Canpolat ET, Caliskan K, et al. Scrotal calcinosis due to resorption of cyst walls: A case report. J Med Case Rep 2008;2:375.  Back to cited text no. 11
12.Chang CH, Yang CH, Hong HS. Surgical Pearl: Pinch-Punch excisions for scrotal calcinosis. J Am Acad Dermatol 2004;50:780-1.  Back to cited text no. 12

Correspondence Address:
Hassen Khouni
Department of Surgery, F.S.I Hospital La Marsa, La Marsa
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Source of Support: None, Conflict of Interest: None

PMID: 21422646

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  [Figure 1], [Figure 2], [Figure 3]


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