Idiopathic Scrotal Calcinosis: Surgical Treatment and Histopathologic Evaluation of Etiology

Karaca, Mustafa; Taylan, Gaye; Akan, Mi̇that; Eker, Güniz; Gideroğlu, Kaan; Gül, Aylin

doi:10.1016/j.urology.2010.02.001

Cited by 18 publications

(17 citation statements)

References 15 publications

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“…Wright et al (20); by performing antikeratin antibodies in multiple sections of 63 lesions from nine patients, couldn't show any epithelial structure in or around the calcified nodules. Karaca et al (21); also reported two cases with no remnants of epithelial cysts. Some other reports also emphasized the absence of true cyst wall (22,23).…”

Section: Discussionmentioning

confidence: 93%

Scrotal Calcinosis: A Case Report And Review Of Literature

Kiremitci¹,

Yüksel²,

Anafarta³

et al. 2011

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Section: Discussionmentioning

confidence: 93%

Scrotal Calcinosis: A Case Report And Review Of Literature

Kiremitci¹,

Yüksel²,

Anafarta³

et al. 2011

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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“…In 2010, Karaca and colleagues reported 2 cases discussing its possible etiology and treatment. 11 In 2011, Khallouk and colleagues reported a similar case of ICS, in which they took on the surgical approach. 3 In the same year, Grenader and colleagues reported an incidental finding of ICS in a patient with pulmonary embolism who presented to the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic scrotal calcinosis: A rare entity and a review of the literature

Pompeo

Molina

Pohlman

et al. 2013

CUAJ

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Scrotal calcinosis is a rare condition with presentation including intradermal nodules varying in size and number. Differentials include calcification of epidermal or pilar cysts noted by the presence of keratinaceous debris. We present 2 cases of scrotal calcinosis at our institution. IntroductionIdiopathic scrotal calcinosis (ISC) was first described in 1883 by Lewinski. 1 The clinical presentation of ISC includes gradual growth of brown-yellow, firm solitary or multiple nodules on the scrotal skin. This rare, benign condition of uncertain etiology typically begins in adolescence or early adulthood and occurs in the absence of abnormalities in calcium and phosphate metabolism. 2 The intradermal nodules tend to increase in size and number over time and can produce a white, chalky material. While these lesions are usually asymptomatic, some patients report pain and itching and there have also been reports of infection associated with ISC. Indications for surgery include relief of symptoms and preservation of scrotal cosmesis. The only treatment recommended for ISC is surgery, which allows for pathologic confirmation of the disorder. 3 We present 2 cases of this rare pathology treated surgically, as well as review of the current literature. Case 1A 22-year-old male was referred to the urology clinic with a 2-year history of asymptomatic scrotal nodules that had gradually increased in size and number. He denied history of scrotal trauma; he also had no history of any metabolic, systemic, neoplastic or autoimmune disease. The increasing number and size of the nodules were affecting his quality of life. He reports that he has avoided intimate relationships because he is embarrassed of his scrotal lesions. He also described increased itching secondary to the lesions. On physical examination, the patient was healthy and in no acute distress. The only significant findings on exam were multiple palpable dark yellow and brown subcutaneous nodules on the scrotum with no pain on palpation. The calcified nodules involved most of the entire scrotum (Fig. 1). His clinical findings were consistent with the working diagnosis of ISC. These lesions were confined to the scrotum with no other skin lesions elsewhere. His testes were palpably normal. Laboratory evaluation revealed a normal serum calcium, phosphorus and parathyroid hormones level.The patient was taken to the operating room where general anesthesia was administered. The involved scrotal skin was excised using multiple elliptical incisions to preserve some uninvolved skin to allow for adequate coverage for skin closure. The scrotal skin excised did not involve the dartos fascia. Several smaller calcifications were also excised individually. All of the defects were closed using 4-0 chromic suture in an interrupted fashion. The patient has not experienced any postoperative complications to date and he has fortunately had a good scrotal cosmetic outcome (Fig. 2). Pathologic analysis revealed extensive large and small dermal calcium deposits with fibrosis, epiderm...

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“…It is characterized by multiple calcified nodules in the scrotal skin, which are not associated with atheromas or dermoid cysts [2,3]. The disease was first reported by Lewinski [6 ]in 1883 and was named ISC by Shapiro et al [7].…”

Section: Discussionmentioning

confidence: 99%

“…Idiopathic scrotal calcinosis (ISC) is a rare, benign disease of uncertain cause, which typically presents in adolescence or early adulthood with multiple calcified nodules in the scrotal skin [1,2,3,4,5]. The possibility of recurrence has been debated, but no case of recurrence has previously been reported.…”

Section: Introductionmentioning

confidence: 99%

Relapse of Scrotal Calcinosis 7 Years after Primary Excision

Sugihara¹,

Tsuru²,

Kume

et al. 2013

Urol Int

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Idiopathic scrotal calcinosis is a rare, benign condition characterized by progressive calcification of the scrotal skin. A 29-year-old man who had undergone primary surgical excision of idiopathic scrotal calcinosis 7 years previously presented with recurrence that he had first noticed 3 years after surgery. Multiple yellowish nodules were observed in the scrotal skin and were confirmed by computed tomography. He underwent repeat resection without any postoperative complications. Histological examination of the surgical specimens revealed diffusely calcified areas within and beneath the squamous epithelium, some of which were associated with epithelial cysts. Immunopathological stains for antibodies against carcinoembryonic antigen, epithelial membrane antigen, and gross cystic disease fluid protein-15 were negative. This is the first reported case of recurrence of scrotal calcinosis. One possible reason for the relapse is that there were remnant seeds of calcification after the primary surgery. This case demonstrates the importance of careful identification and resection of all calcified areas, and of counseling patients about the possibility of relapse after surgical treatment.

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Idiopathic Scrotal Calcinosis: Surgical Treatment and Histopathologic Evaluation of Etiology

Cited by 18 publications

References 15 publications

Scrotal Calcinosis: A Case Report And Review Of Literature

Scrotal Calcinosis: A Case Report And Review Of Literature

Idiopathic scrotal calcinosis: A rare entity and a review of the literature

Relapse of Scrotal Calcinosis 7 Years after Primary Excision

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