Mobile calcifications within the tunica vaginalis are often referred to as “scrotal pearls”. In general, extratesticular calcifications are more common than intratesticular calcifications and ususually related to benign processes. The etiology of scrotal pearls is often related to torsion of the epididymal or testicular appendages or fibrinous degeneration of the tunica; in infants, meconium peritonitis can be considered. Scrotal pearls are most often solitary but can be multiple and are often associated with hydrocele.
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