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Chronic complicated hydrocele with eggshell calcification: A case report

Alper Dilli, Umit Yasar Ayaz, Osman Raif Karabacak, Hikmet Topaloglu, Demet Yılmazer, Baki Hekimoglu

Med Sci Tech 2011; 52(1-2): CR79-82

ID: 882082

Background:    We present a rare case of a large, chronic, complicated hydrocele, radiographically demonstrating abundant, peripheral eggshell calcification.
    Case Report:    A 65-year-old man had painless swelling on the right side of his scrotum for 6 years with no history of scrotal trauma. Physical examination revealed a large, firm scrotal mass on the right side. On US, a complicated cystic mass measuring 13×6×6 cm and having a thick hyperechogenic wall with posterior acoustic shadowing representing wall calcification was detected in the right hemiscrotum. On MRI, a hypointense right scrotal mass on T2-weighted and T1-weighted images was demonstrated. In dynamic Thrive (T1) sequence, a small, deformed, contrast-enhancing right testis was demonstrated inferior to the mass. On a single, low-dose plain radiography, diffuse calcifications resembling eggshell were seen to cover the right hemiscrotum like a mantle. The cystic mass was removed with the right testis by high inguinal orchiectomy. The complicated cystic mass was filled with inspissated creamy material. The right testis showed atrophic changes.
    Conclusions:    Histopathological examination was reported as hyalinization and dystrophic calcification in seminiferous tubules and tunica albuginea, sclerosis in seminiferous tubules, and peritesticular and periepididymal fibrosis. No malignant change was reported. Radiological findings were consistent with gross pathological and histopathological findings.

Keywords: Testicular Hydrocele - complications, Calcinosis, Ultrasonography, Magnetic Resonance Imaging

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