Testicular microlithiasis is a relatively uncommon condition with a small calcification of both testicles.
The primary standard of diagnosis is that there are 5 small stones in a testicle, although definitions have varied in the past. In most cases, the small testicular stones are bilateral.
Testicular small stones are found in up to 0.6% of patients undergoing testicular ultrasound. Some reports suggest that up to 5.6% of the general population is between the ages of 17 and 35 (3). Although small testicular stones are present in about 50% of men with germ cell tumors, this is very common in patients without cancer, and the direct association between them is still debated.
- Testicular germ cell tumors
- Klinefelter syndrome
- Hidden testicles
- Testicular infarction
- Testicular granulomatosis
- Infertility (17)
- Down syndrome
- Aveolar microlithiasis (Aveolar microlithiasis)
Clinical symptoms of testicular microscopy
Testicular small stones are asymptomatic and are often found by an ultrasound examination of the testicles, or found in symptomatic conditions.
Microcalcification may be an indicator of duct degeneration, but is not a risk factor for duct degeneration (10).
Ultrasound characteristics of small testicular bronchoscopy
An ultrasound is the method of choice for examining the testicles. Small pebbles that appear are thick, non-glossy echoes of the back small size limited to 1-3mm in diameter. These spots are usually of the same size, appear within the testicular parenchyma and evenly distributed, or may be distributed peripheral or clumped (2).
A classification flow chart used in ultrasound is suggested as (13):
- Limited TML: less than 5 microcalcifications / cross section.
- Classic TML: greater than or equal to 5 microcalcifications / cross section.
- TML diffuse: many microcalcification nodules
TREATMENT AND PROSPECTS SMALL COMPULSORY DISEASE
Testicular small stones are asymptomatic and benign. The association of testicular tumors, particularly germ cell tumors (GCT), remains controversial. An approximately 12-fold increased risk of GCT in symptomatic testicles with small stones has been reported (with small stones found in almost 50% of CTG cases), however, no increased risk was found. asymptomatic on testicles. It’s also not clear if early detection has any benefit over self-examination. Hence, screening is unlikely to be beneficial (1.17).
Some publications recommend frequent self-examination rather than ultrasound examination, while others recommend annual follow-up ultrasound when accompanied by other pre-malignant factors.
The ESUR recommends follow-up ultrasound to age 55, only when there are risk factors including:
- Hidden testicles
- Testicular surgery
- Testicular atrophy (e.g. volume less than 12cc)
- Germ cell pre-tension (15)
- Family history of germ cell tumors.
Translated from: https://radiopaedia.org/
Dr. Dang Xuan Ky
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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
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11. de Gouveia Brazao CA, Pierik FH, Oosterhuis JW et-al. Bilateral testicular microlithiasis predicts the presence of the precursor of testicular germ cell tumors in subfertile men. J. Urol. 2004; 171 (1): 158-60. wait: 10.1097 / 01.ju.0000093440.47816.88 – Pubmed citation
12. Richenberg J, Belfield J, Ramchandani P et-al. Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee. Eur Radiol. 2015; 25 (2): 323-30. wait: 10.1007 / s00330-014-3437-x – Pubmed citation
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14. Thomas C. Winter, Bohyun Kim, William T. Lowrance, William D. Middleton. Testicular Microlithiasis: What Should You Recommend ?. (2016) American Journal of Roentgenology. 206 (6): 1164-9. wait: 10.2214 / AJR.15.15226 – Pubmed
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