Scrotal calcinosis: pathogenetic link with epidermal cyst

Abstract

Scrotal calcinosis is a rare entity characterised by multiple calcified nodules in the scrotal skin. Various pathogenetic mechanisms have been postulated in the literature to explain the origin of these nodules; however, debate continues among variable opinions and evidence. We report two cases of scrotal calcinosis developing from an epidermoid cyst with demonstration of pathology at various stages, thereby suggesting calcification of epidermal cysts as an initiating event in the pathogenesis of the disease, at least in a few cases.

Figure 1

(A) Gross photograph of the scrotum showing a large single cystic structure surrounded by multiple calcified nodules of varying size. (B) Gross photograph of another case showing small whitish calcified nodules over the external surface of the scrotum.

Figure 2

Sequential microphotographs demonstrating evolution of the disease. (A) Precursor cystic structure lined by a stratified squamous epithelium, (B) Another cyst with an attenuated epithelium and minute calcific deposits in the wall, (C) Large calcific deposits at one aspect of the cyst and (D) Calcified nodules devoid of any lining epithelium representing the terminal stage of the disease.