Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Pathology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
J Med Case Rep. 2023 Aug 15;17(1):363. doi: 10.1186/s13256-023-04076-9.
Hydrocele, an abnormal fluid collection between parietal and visceral layers of the tunica vaginalis, is the commonest cause of scrotal swelling, and it affects all age groups. Calcification of hydrocele sac/wall is a rare clinical entity. The etiology of calcification of hydrocele sac is not clear, but most literature proposes that calcification is secondary to chronic irritation. Trauma and infectious diseases including Schistosoma haematobium, filariasis, and tuberculosis can also cause calcification of the hydrocele sac.
A 74-year-old Ethiopian male patient presented with left side scrotal swelling of 3 years duration, which was initially small but progressively increased. He had no history of trauma, and he had no history of swelling on the contralateral side. Scrotal ultrasound (US) showed a large echodebrinous left-side scrotal collection with calcifications, bilateral testis appear normal in size, echogenicity, and color Doppler flow with the index of likely chronic hematocele. Therefore, with a diagnosis of left-sided calcified hydrocele, the patient was operated on and the calcified sac was excised and sent for histopathology. Finally, the patient was discharged improved after 2 days of hospital stay.
Calcification of the tunica vaginalis is very rare and is probably due to chronic irritation of the wall from the coexisting hydrocele. Surgical excision of calcified hydrocele sac is the treatment of choice.
鞘膜积液是一种在鞘膜壁层和脏层之间异常积聚液体的疾病，是导致阴囊肿胀的最常见原因，可发生于所有年龄段。鞘膜囊/壁钙化是一种罕见的临床现象。鞘膜囊钙化的确切病因尚不清楚，但大多数文献认为钙化是慢性刺激的结果。创伤和包括埃及血吸虫、丝虫和结核在内的传染性疾病也可导致鞘膜囊钙化。
一名 74 岁的埃塞俄比亚男性患者因左侧阴囊肿大 3 年就诊，最初肿块较小，但逐渐增大。患者无外伤史，对侧阴囊无肿胀史。阴囊超声（US）显示左侧阴囊有一个大的有回声的鞘膜积液积聚，伴有钙化，双侧睾丸大小、回声和彩色多普勒血流指数均正常，提示可能为慢性血性鞘膜积液。因此，诊断为左侧钙化性鞘膜积液，对患者进行了手术，切除了钙化的囊，并送去进行组织病理学检查。最终，患者在住院 2 天后出院，病情改善。
鞘膜壁钙化非常罕见，可能是由于同时存在的鞘膜积液对壁的慢性刺激所致。钙化性鞘膜积液囊的手术切除是首选治疗方法。
