Scrotolith
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose.
View Daniel J Bell's current disclosures- Scrotal pearls
- Scrotoliths
- Scrotal calculi
- Scrotal calculus
- Scrotal stone
- Scrotal stones
Scrotoliths, also known as scrotal pearls, are benign incidental extratesticular macrocalcifications within the scrotum. They frequently occupy the potential space of the tunica vaginalis or sinus of the epididymis. They are usually of no clinical significance 1,2.
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Epidemiology
The prevalence of scrotoliths has been estimated to be approximately 3% 3.
Clinical presentation
Most scrotoliths are asymptomatic.
Pathology
Possible etiologies include:
reactive fibrous proliferation during intrascrotal inflammation microtrauma to the scrotal region, e.g. mountain bikers
calcified loose bodies from prior torsion of the testicular appendix
Radiographic features
Ultrasound
Ultrasound usually shows a small mobile hyperechoic extratesticular focus in the potential tunica space. If large enough, the pearl usually has posterior acoustic shadowing. It may be free floating if there is an accompanying hydrocele.
Most scrotoliths are less than 1 cm in size 6. However occasionally they can be substantially larger, up to 8.7 cm has been reported (in 2024) 7.
References
- 1. Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. (2003) Radiology. 227 (1): 18-36. doi:10.1148/radiol.2271001744 - Pubmed
- 2. Black JA, Patel A. Sonography of the abnormal extratesticular space. (1996) AJR. American journal of roentgenology. 167 (2): 507-11. doi:10.2214/ajr.167.2.8686637 - Pubmed
- 3. Artas H, Orhan I. Scrotal calculi. (2007) Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 26 (12): 1775-9. doi:10.7863/jum.2007.26.12.1775 - Pubmed
- 4. Kühn AL, Scortegagna E, Nowitzki KM, Kim YH. Ultrasonography of the scrotum in adults. (2016) Ultrasonography (Seoul, Korea). 35 (3): 180-97. doi:10.14366/usg.15075 - Pubmed
- 5. Mittal PK, Abdalla AS, Chatterjee A, Baumgarten DA, Harri PA, Patel J, Moreno CC, Gabriel H, Miller FH. Spectrum of Extratesticular and Testicular Pathologic Conditions at Scrotal MR Imaging. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (3): 806-830. doi:10.1148/rg.2018170150 - Pubmed
- 6. Borthakur D, Dada R, Kumar R, Jacob T. Scrotoliths in the Testicular Tunica Vaginalis in an Elderly Male Cadaver: Clinical Implications. FM. 2024;66(4):574-7. doi:10.3897/folmed.66.e121058 - Pubmed
- 7. Li G, Li X, Cheng S, Chen Z. A Large Intrascrotal Calculus. Asian J Androl. 2005;7(1):103-5. doi:10.1111/j.1745-7262.2005.00013.x - Pubmed
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