Abstract Scrotal skin calcinosis is a rare benign dis-
ease; in most cases there are no associated symptoms. A
40-year-old patient with massive involvement of the
scrotum is presented. Histological examination of the ex-
cised material revealed circular deposits of calcium with-
in the dermis without evidence of epithelialized lining.
The pathogenesis is discussed regarding hypotheses pre-
sented in the literature.
Keywords Surgery · Scrotum · Idiopathic calcinosis ·
Calcinosis of the scrotum is a rare condition which usu-
ally presents as asymptomatic yellow to erythematous
nodules of the scrotal skin in otherwise healthy young
men. The number of calcified nodules can vary from one
to several hundreds. Calcinosis of the scrotum is often
misdiagnosed clinically as epidermal cysts.
Fewer than 100 cases of the condition have been re-
ported to date and pathogenesis remains controversial [1,
2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14,15]. We describe a
case with massive involvement of the scrotum.
A 40-year-old Caucasian male presented with major scrotal in-
volvement diagnosed as “cysts”. His medical history revealed that
the lesions had been present for several years and were slowly
growing without any symptoms. There was no family history of a
similar complaint and the patient was otherwise healthy.
On examination it was revealed that there were hundreds of
oval, non-tender, yellowish nodular lesions of varying sizes
(0.5–2 cm) (Fig. 1). Serum calcium and phosphate levels were
within normal limits.
Under general anesthesia, the involved area was completely
excised. A local plasty was performed to close the 14×15-cm de-
fect. Healing was uneventful (Fig. 2).
Microscopic examination showed circular deposits of calcium
within the dermis, surrounded by bands of fibrous tissue but with-
out evidence of a true epithelial cyst wall. Multinucleated giant
cells were present focally at the periphery of some nodules.
Scrotal calcinosis is a rare clinical condition, character-
ized by the presence of firm painless nodules of the scro-
tal wall. Sometimes there might be some heaviness or
itching; spontaneous discharge of the calcified masses or
secondary infection of the enclosed material has been de-
scribed [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14,15].
There is often a long delay between onset of the dis-
ease and therapy because of the benign course and negli-
gible symptoms encountered by the patient.
E. Vandeweyer (
Department of Plastic and Reconstructive Surgery,
Jules Bordet Cancer Institute, Rue Héger-Bordet,
1000 Brussels, Belgium
Tel.: +32-2-5413277, Fax: +32-2-5413141
Department of Urology, Jules Bordet Cancer Institute,
Rue Héger-Bordet, 1000 Brussels, Belgium
Eur J Plast Surg (2001) 24:98–99
E. Vandeweyer · A. Peltier
Massive scrotal calcinosis
Received: 13 September 2000 / Accepted: 19 December 2000 / Published online: 23 February 2001
© Springer-Verlag 2001
Fig. 1 Preoperative appearance of the scrotum