[Bilateral scrotal panniculitis in a prepubescent child]

Scrotal panniculitis or scrotal fat necrosis is an uncommon acute scrotal pathology. We report a case of scrotal fat necrosis in a 9 1/2 year-old over-weight boy with bilateral tender scrotal masses, located beneath the tests. Pathologic findings were those of subcutaneous fatty indurated masses with lipogranulomatous foci. The etiology of scrotal fat necrosis is unknown. A similar condition has been described in young children exposed to cold. In obese prepubescent boys, a greater sensitivity to cold and a higher saturated fatty acid concentration of the scrotal adipose tissue would induce fat necrosis. Our study of fatty acid composition by gas-liquid chromatography showed an elevation of stearic acid. The spontaneous resolution of scrotal fat necrosis is always the rule and allows symptomatic treatment without surgical investigation.