Scrotal Fat Necrosis

Synonyms

Fat necrosis of the scrotum

Definition

Firm nodules in the lower part of the scrotal wall.

Clinical Features

• Incidence

  It occurs in stout or fat boys before puberty. It represents 1% of the acute pediatric lesion arising in the scrotum (Murphy et al. 2006).

• Age

  It affects children and adolescents.

• Sex

  Male

• Site

  Scrotum: usually the lesions are bilateral and symmetrical (Peterson et al. 1976). The testis is not involved.

• Treatment

  Most cases are conservatively managed. When diagnosis is not clear clinically, lumpectomy is advocated.

• Outcome

  Benign

Macroscopy

Ill-defined gray-yellow nodules limited to the scrotal wall.

Microscopy

Histologically, the lesions show fat necrosis with inflammation (Ong and Solomon 1973).

Differential Diagnosis

Biopsies in this setting are exceptional; the diagnosis in the majority of the cases is clinically done (history of cold exposure prior to the onset of scrotal pain and ultrasound evaluation). Differential diagnosis must be done with fat tumors...