Testicular microlithiasis

• Testicular microlithiasis (TM)
  • this is an uncommon condition characterized by calcium deposits within the seminiferous tubules
  • ultrasound appearance
    • multiple, uniform, nonshadowing echogenic foci in the testis
  • prevalence
    • true prevalence in the general population is still unknown - reported prevalence range is from 0.6% to 9%
  • associations with testicular cancer:
    • there is a reported association between TM and possible subsequent germ cell tumor (GCT) or intratubular germ cell neoplasia
    • incidence of GCT in patients with TM was reported as 6% to 46%
  • significance of TM
    • there are several reports demonstrating interval development of GCT in patients with TM - these may suggest a premalignant nature of TM (1)
      • however, more recent studies show a lower incidence of associated GCT and no interval development of tumor in relatively longer duration follow-up
      • suggested that both TM and testicular GCT may be caused by a common defect such as tubular degeneration and TM may present as a marker for such abnormalities (1,2)
  • management
    • seek specialist advice
    • some suggest (1), because of a high incidence of association with GCT, it is prudent to follow up patients with TM with physical examination and ultrasound at least annually and to encourage self-examination
      • routine use of biochemical tumor markers, abdominal and pelvic CT or testicular biopsy does not seem to be justified

Reference:

• (1) Eur Radiol. 2003 Dec;13(12):2567-76 .
• (2) Kim B. Testicular tumor and microlithiasis Ultrasound in Medicine and Biology 2006; 32 (5): 82.