Benign but bizarre: A case report on idiopathic scrotal calcinosis

TL;DR

This case report describes a rare, benign condition called idiopathic scrotal calcinosis, its symptoms, diagnosis, and effective surgical treatment.

Contribution

The paper presents a detailed case report and emphasizes the benign nature and management of idiopathic scrotal calcinosis.

Findings

Idiopathic scrotal calcinosis is a rare, benign condition presenting as asymptomatic nodules in the scrotum.

Surgical excision with reconstruction is the preferred treatment, offering excellent cosmetic and functional outcomes.

The condition is often underreported due to patient embarrassment or fear of cancer.

Abstract

Calcinosis cutis, also known as calcification in soft tissue, is an uncommon benign condition that can be further classified into idiopathic, dystrophic, iatrogenic, metastatic, and calciphylaxis subtypes. The scrotum is one area where calcinosis cutis frequently occurs. During years or decades, the nodules gradually enlarge. The scrotal calcinosis cutis can be solitary or multiple, typically asymptomatic, hard, yellowish marble-like, polypoidal. Despite being benign, patients with this condition present late due to shyness or cancer anxiety, even when faced with sexual discomfort and infertility. In this article, we want to raise awareness to highlight benignity of this condition, various treatment options and good prognosis associated with the disease.

A 38-year-old male presented with multiple painful, itchy scrotal swellings and infertility. Examination revealed scrotal nodules, absent left testis, and aspermia. Histopathology confirmed scrotal calcinosis. Total scrotectomy was performed with right testis repositioned in the thigh. Patient was referred for infertility management after successful surgical recovery.

Idiopathic calcinosis cutis of the scrotum (ICCS) is a benign, slow-growing condition often presenting in adulthood with asymptomatic yellowish nodules. Diagnosis is confirmed histologically. Though idiopathic, it may involve dystrophic calcification of epidermoid cysts. Surgical excision with scrotal reconstruction is the preferred treatment, offering excellent cosmetic and curative outcomes.

Being usually asymptomatic, ICCS is a benign disorder. It appears as a series of successive, different-sized nodules. A histological evaluation shows the calcified regions. One of two possible causes exists: idiopathic or dystrophic calcification of cysts. Excision is the preferred course of action.

•Definition and Rarity: Rare benign calcium deposition in scrotal skin, presenting as firm, asymptomatic nodules.•Case Summary: 38-year-old male with multiple scrotal nodules for 10 years, aspermia, absent left testis, histology confirmed ICCS.•Treatment: Total scrotectomy done, right testis shifted to thigh pocket, suction drain placed to avoid fluid buildup.•Pathophysiology Debate: Cause debated—either idiopathic or from dystrophic calcification of ruptured epidermoid cysts.•Diagnosis and Management: Histology confirms diagnosis; surgical excision with reconstruction prevents recurrence and ensures good results.

Definition and Rarity: Rare benign calcium deposition in scrotal skin, presenting as firm, asymptomatic nodules.

Case Summary: 38-year-old male with multiple scrotal nodules for 10 years, aspermia, absent left testis, histology confirmed ICCS.

Treatment: Total scrotectomy done, right testis shifted to thigh pocket, suction drain placed to avoid fluid buildup.

Pathophysiology Debate: Cause debated—either idiopathic or from dystrophic calcification of ruptured epidermoid cysts.

Diagnosis and Management: Histology confirms diagnosis; surgical excision with reconstruction prevents recurrence and ensures good results.

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