Multiple scrotal nodules in a patient with a history of syphilis: A case report of idiopathic scrotal calcinosis

Çubukçu S. S., Okcu O., Öztürk Ç.

38th European Congress of Pathology, Stockholm, İsveç, 12 - 16 Eylül 2026, cilt.489, ss.962, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 489
  • Basıldığı Şehir: Stockholm
  • Basıldığı Ülke: İsveç
  • Sayfa Sayıları: ss.962
  • Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

Background & Objectives: Idiopathicscrotalcalcinosis (ISC) is a rare, benign condition characterised by the slow growth of painless calcium deposits within the scrotal skin. The pathogenesis of ISC remains debated, particularly whether the calcifications arise from ruptured epidermoid cysts or are strictly idiopathic. In patients with a history of sexually transmitted infections (STIs), it is clinically essential to distinguish ISC from syphilitic gummas or infectious granulomas. This report presents a case involving a 43-yearold male with a history of syphilis. Methods: A 43-year-old man presented with approximately ten painless nodules on his scrotum. Due o his history of treated syphilis, surgical excision was performed to obtain a diagnosis and improve the appearance of the area. Macroscopic examination of the excised tissue revealed hard, chalky, yellow-white calcified material embedded in the dermis, measuring up to 2.5 cm. Microscopic analysis demonstrated normal squamous epithelium overlying the area. Within the dermis, extensive, amorphous, basophilic calcification foci were observed. These deposits lacked an epithelial lining and were surrounded by a granulomatous inflammatory reaction comprising histiocytes, lymphocytes and foreign-body-type giant cells. Results: Importantly, even though the patient had a history of syphilis, there were no signs of it in the tissue samples, including the inflammation of the arteries, the build-up of plasma cells, or the death of tissue. The diagnosis of ISC was confirmed Conclusion: ISC is a benign condition that is often misdiagnosed as an epidermal cyst or infectious nodule. Although a history of syphilis may raise suspicion of infectious granulomas, a definitive diagnosis requires histopathological analysis. The absence of an intact cystic epithelium surrounding calcified foci supports an idiopathic origin and excludes infectious aetiologies. Surgical excision remains the gold standard, offering a definitive diagnosis and effective treatment