Idiopathic scrotal calcinosis
Presentation
Hip pain. Old sports related injury to the right leg that required hospitalization.
Patient Data
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The right hip demonstrates extensive osteophyte proliferation involving the femoral head and acetabular rim. There is also mild joint space narrowing. A healed fracture deformity is present at the mid-diaphysis of the right femur, with moderate anterior offset and dorsal angulation of the distal femur relative to the proximal. Several small homogenously dense calcific bodies are present near the left femoral neck which may be intraarticular, however can not be specifically localized.
Within the scrotum, numerous homogenously dense calcifications of varying size are present, several of which are superficial and distort the contour of the scrotal skin.
Case Discussion
Idiopathic scrotal calcinosis is a rare condition of unknown etiology, however two favored possible pathogenic mechanisms include:
1. Dystrophic calcification epidermal inclusion cysts.
2. Necrosis and degeneration of the dartos muscle leading to dystrophic calcifications.
In any case, this entity is benign and the calcifications amenable to surgical excision as they are quite superficial, however may recur if incompletely excised. Affected men are typically between 20 and 40 years of age.