|Year : 2019 | Volume
| Issue : 1 | Page : 91-92
Gargantuan primary scrotal calcinosis – Surgical, cosmetic, and sociopsychiatric concern
Poonam Elhence1, Ramkaran Chaudhary2
1 Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
2 Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
|Date of Submission||18-Feb-2018|
|Date of Acceptance||04-Sep-2018|
|Date of Web Publication||21-Jan-2019|
Dr. Poonam Elhence
Department of Pathology, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan
| Abstract|| |
A 47-year-old healthy male had a scrotal lesion for about 10 years which was gradually increasing in size and not associated with pain or tenderness. It was dwarfing the penis and attained its present size of 14 cm × 7.5 cm × 6 cm. There were no discharging sinuses, tenderness, or ulceration. He had no significant past or family history. Laboratory examination revealed unremarkable serum calcium, serum phosphate, serum total protein, serum uric acid, and serum parathormone levels. A clinical diagnosis of epidermal inclusion cysts was suggested. The lesion was entirely excised and sent for histopathologic examination.
Keywords: Gargantuan, primary scrotal calcinosis, surgical treatment
|How to cite this article:|
Elhence P, Chaudhary R. Gargantuan primary scrotal calcinosis – Surgical, cosmetic, and sociopsychiatric concern. Urol Ann 2019;11:91-2
| Introduction|| |
Calcinosis has been described at several sites and due to various reasons like increased parathormone and calcium levels, in tumours, in scars and areas of necrosis. Calcinosis in the genital region is uncommon. Lesions in the scrotum present as one to multiple hard nodules which may ulcerate the skin and cause a chalky white discharge. Initially, scrotal calcinosis was thought to be idiopathic in origin. Now it is surmised to arise either from calcification in a pre-existing epidermoid cyst or due to calcification of contents of dilated eccrine glands in the dermis. We describe the case of an adult male with one such gargantuan lesion in the scrotum.
| Case Report|| |
A 47-year-old healthy male had a scrotal lesion for about 10 years which was gradually increasing in size and not associated with pain or tenderness. It was dwarfing the penis and attained its present size of 14 cm × 7.5 cm × 6 cm [Figure 1], [Figure 2]. The lesion was entirely excised and sent for histopathologic examination.
Microscopic examination of 5-μ thick hematoxylin and eosin (H and E)-stained sections showed skin with unremarkable epidermis with multiple foci of dystrophic calcification and focal foreign body multinucleated giant cell reaction in the dermis, consistent with massive idiopathic scrotal calcinosis [Figure 3] and [Figure 4]. Scrotal calcinosis is a rare benign condition of unknown etiopathogenesis presenting with multiple, firm-to-hard scrotal swellings. Surgical excision with scrotoplasty is an effective treatment modality, though the lesion may recur. The patient is on follow-up for 2 years with no recurrence [Figure 5].
|Figure 3: Skin with unremarkable epidermis with multiple foci of dystrophic calcification (H and E, 2x)|
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|Figure 4: Multiple foci of dystrophic calcification with foreign-body multinucleated giant cell reaction (H and E, 10x)|
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| Discussion|| |
Scrotal calcinosis is a rare, benign, enigmatic, and disfiguring lesion which is a cause for social and psychiatric concern. Multiple, slow-growing, firm-to-hard, yellowish-white nodules of varying sizes are seen in the dermis of the scrotal skin., These nodules are calcified and associated with foreign-body giant cell reaction. The etiopathogenesis is controversial with some authors favoring origin from calcification of preexisting structures as in the epidermal cysts and others favoring its idiopathic nature.,
Surgical excision with scrotoplasty is an effective treatment modality, though they may recur., The patient is on follow-up for 2 years with no recurrence.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]