Sclerosing lipogranuloma: an unusual scrotal mass

Sclerosing lipogranuloma of the male genitalia without a history of injection of exogenous material is extremely rare. This is the first case reported from a Canadian center. This 33 year old man developed sclerosing lipogranuloma of his scrotum 3 months after being diagnosed with infectious mononucleosis. There was no history of injection of exogenous substances or trauma. His lesion was painless, sudden in onset, "Y-shaped", associated with eosinophila and spontaneously regressed after partial resection. A review of the available English literature on sclerosing lipogranuloma from 1966 to 2001 was completed to compare our case report to previously available reports. The results show definite differences in the presentation of primary versus secondary sclerosing lipogranuloma. Sixty-eight per cent of the cases of primary sclerosing lipogranuloma involved the scrotum only while 63% of secondary sclerosing lipogranuloma involved the penis only. Seven per cent of lesions attributed to primary sclerosing lipogranuloma were painful compared to 69% of secondary sclerosing lipogranulomas. Cases of primary sclerosing lipogranuloma were often described as "Y-shaped" and were unlikely to recur. Understanding the typical presentation of this condition will allow future cases to be recognized more easily and managed appropriately. Primary sclerosing lipogranuloma may be diagnosed by fine needle aspiration or excisional biopsy and then managed conservatively avoiding more complex and invasive surgery.