Idiopathic scrotal calcinosis: a rare case report and review of pathogenesis and surgical management

Abstract

Scrotal calcinosis is an uncommon benign disorder of the scrotal skin characterized by multiple calcified intradermal nodules that occurs in the presence of normal calcium and phosphate metabolism. The pathogenesis of scrotal calcinosis is still controversial. Our Aim is to report this disease in 33-years-old man and review the pathogenesis and surgical management. We presented 33-years-old male patient with a 10 year history of painless scrotal nodules which gradually increased in size and number. Physical examination revealed multiple scrotal nodules with diameter of 5-10 mm, respectively. The nodules were firm and skin-colored. The nodules grow from small bud with chalky white exudative discharge but no history of vesicle, papule or any sign of inflammation. The patient’s symptoms were mild itching with no pain. He had no history of trauma, malignancy, or any metabolic disorder. His old brother had a history with the same complained. Laboratory findings including serum electrolyte and level of creatinine, urea, calcium and phosphorus, were within normal limit. The patient was performed biopsy before procedure showed dystrophic calcinosis appearance. We performed wide local excision of lesion with primarily closure with good postoperative outcome, with histopathology result calcinosis subcutaneous at region scrotum. Dystrophic scrotal calcinosis is a benign condition which can affect a patient’s quality of life. Irrespective of the etiology, surgical excision seems to be gold standart is required both for confirming the diagnosis as well as for treatment but occasionally may require complex scrotal reconstruction to provide a good clinical outcome with good patient satisfaction.