Scrotoliths, also known as scrotal pearls, are benign incidental extra testicular macro-calcifications within the scrotum. They frequently occupy the potential space of the tunica vaginalis or sinus of the epididymis. They are usually of no clinical significance .
The prevalence of scrotoliths has been estimated to be approximately 3% .
Most scrotoliths are asymptomatic.
Possible etiologies include:
- microtrauma to the scrotal region, e.g. mountain bikers
- prior torsion appendix of testis
Usually shows a mobile hyperechoic extratesticular focus in the potential tunica space. If large enough, the pearl usually has posterior acoustic shadowing. It may be free floating if there is an accompanying hydrocele.