Testicular microlithiasis is a relatively common condition that represents the deposition of multiple tiny calcifications throughout both testes.
Testicular microlithiasis is seen in up to 0.6% of patients undergoing scrotal ultrasound. Although testicular microlithiasis is present in about 50% of men with a germ cell tumour, it is very common in patients without cancer, and a direct relationship between the two is contentious.
Testicular microlithiasis per se is asymptomatic, and is usually found incidentally when the scrotal content is examined with ultrasound, or found in association with symptomatic associated conditions.
Known associations include:
- testicular germ cell tumour
- Kleinfelter syndrome
- testicular infarct
- Down syndrome
- alveolar microlithiasis
Ultrasound is the modality of choice for examining the testes. Microlithiasis appears as small non-shadowing hyperechoic foci ranging in diameter from 1 to 3 mm. These foci occur within the testicular parenchyma and although usually distributed uniformly, may be distributed peripherally or segmentally 2.
In the vast majority of cases testicular microlithiasis is found bilaterally.
Treatment and prognosis
Testicular microlithiasis is in itself asymptomatic and benign. A relationship between testicular tumours (in particular germ cell tumours (GCT)) is controversial. An ~ 8 fold increased risk of GCT in symptomatic testicles with microlithiasis has been reported (microlithiasis is found in approximately 50% of GCT cases), however no increased risk found in asymptomatic testicles. As such screening is unlikely to be beneficial 1.
- 1. Tan IB, Ang KK, Ching BC et-al. Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. 2010;doi:10.1002/cncr.25231 - Pubmed citation
- 2. Cast JE, Nelson WM, Early AS et-al. Testicular microlithiasis: prevalence and tumor risk in a population referred for scrotal sonography. AJR Am J Roentgenol. 2000;175 (6): 1703-6. AJR Am J Roentgenol (full text) - Pubmed citation
Synonyms & Alternative Spellings
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|Microlithiasis of the testes||✓|