testicular microlithiasis

Last reviewed 01/2018

  • 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


  • (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.