Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Calcifying Nodules

  • Caterina Fattorini
  • Antonio Lopez-Beltran
  • Maria Rosaria RaspolliniEmail author
Living reference work entry

Latest version View entry history

DOI: https://doi.org/10.1007/978-3-319-28845-1_4788-2

Synonyms

Definition

Benign condition characterized by presence of single or multiple calcified nodules.

Clinical Features

  • Incidence

    Uncommon condition.

  • Age

    Children and young adults.

  • Sex

    Males.

  • Site

    Skin of scrotum, testis, and paratesticular structures.

  • Presentation
    • Scrotum: Single or multiple mobile masses affecting the skin of this region.

    • Testis: Single palpable mass of varying size near the pole of the organ.

  • Treatment
    • Scrotum: Surgical excision of the symptomatic nodules is sufficient (Khallouk et al. 2011).

    • Testis: Due to the undefined diagnosis before the final histopathologic examination, a partial orchiectomy is frequently performed (Akdemir et al. 2017).

  • Outcome

    Calcifying nodules are benign lesions and the prognosis after excision is excellent.

Macroscopy

Well-circumscribed yellowish nodules, rarely pedunculated (Gi et al. 2008).

Microscopy

Scrotum: Granular and globular deposits of basophilic calcified material (Fig. 1) surrounded by a granulomatous inflammatory response (Song et al. 1988) consisting of histiocytes or giant cells in the dermis of the scrotum. The etiology of this condition is still partially unknown; however, in some cases, the deposition derives from degenerated cysts (such as epidermoid cysts) (Swinehart and Golitz 1982), so remnants of preexisting cystic structures can be identified within the lesion.
Fig. 1

Calcifying nodule of scrotum

Testis: A flattened epithelium covering a core of connective tissue with interspersed fibroblasts, fibrin-like material, and globular deposition of calcium without an inflammatory infiltrate (Nistal and Paniagua 1989).

Immunophenotype

Calcified material is positive for Von Kossa stain, rarely used and necessary.

Differential Diagnosis

Scrotum: The histological examination allows a definitive diagnosis in almost all cases; however, the nodular appearance and the deposition of material in the dermis may be mistaken with the presentation of nodular amyloidosis. In amyloidosis, the homogeneous eosinophilic material is positive for Congo red and negative for Von Kossa stain.

Testis: Radiological studies are not sufficient to distinguish calcifying nodules from malignant testicular lesions while the histological appearance is straightforward.

References and Further Reading

  1. Akdemir, F., Aldemir, M., & Orhun, H. S. (2017). Intratesticular calcified nodule. Turkish Journal of Urology, 43, 563–565.CrossRefGoogle Scholar
  2. Gi, N., Gupta, A. K., Sachi, K., & Thomas, S. (2008). Idiopathic scrotal calcinosis; a pedunculated rare variant. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61, 466–467.CrossRefGoogle Scholar
  3. Khallouk, A., Yazami, O. E., Mellas, S., Tazi, M. F., El Fassi, J., & Farih, M. H. (2011). Idiopathic scrotal calcinosis: A non-elucidated pathogenesis and its surgical treatment. Reviews in Urology, 13, 95–97.PubMedPubMedCentralGoogle Scholar
  4. Nistal, M., & Paniagua, R. (1989). Nodular proliferation of calcifying connective tissue in the rete testis: A study of three cases. Human Pathology, 20, 58–61.CrossRefGoogle Scholar
  5. Song, D. H., Lee, K. H., & Kang, W. H. (1988). Idiopathic calcinosis of the scrotum: Histopathologic observations of fifty-one nodules. Journal of the American Academy of Dermatology, 19, 1095–1101.CrossRefGoogle Scholar
  6. Swinehart, J. M., & Golitz, L. E. (1982). Scrotal calcinosis: Dystrophic calcification of epidermoid cysts. Archives of Dermatology, 118, 985–988.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Caterina Fattorini
    • 1
  • Antonio Lopez-Beltran
    • 2
    • 3
  • Maria Rosaria Raspollini
    • 1
    Email author
  1. 1.Histopathology and Molecular DiagnosticsUniversity Hospital CareggiFlorenceItaly
  2. 2.Pathology ServiceChampalimaud Clinical CenterLisbonPortugal
  3. 3.Unit of Anatomic Pathology, Department of SurgeryCordoba University Medical SchoolCordobaSpain