Incidence of testicular microlithiasis.

In adults polytopic intratubular calcifications of the testes are rare. Known as testicular microlithiasis, they manifest themselves in a characteristic echo pattern on sonography with high-frequency transducers (5 to 10 MHz). This consists of multiple echogenic specks in an otherwise normal testicular parenchyma. In a retrospective analysis of 1,710 testicular sonograms of adults, bilateral intratesticular microliths were found in 11 cases (0.6%). In 5 of them, the microliths were associated with a testicular tumor. One patient with a tumor in the contralateral testis had undergone radiotherapy and another one presented with hypogonadism. Four patients with noncontributory histories presented with varicocele or epididymal cyst. Sonographic findings were confirmed histologically in 6 patients. Multiple intratubular calcifications were found in all of them. The pathogenesis of testicular microliths is still poorly understood. Their clinical relevance is unclear, but their incidence in adults appears to be higher than reported in the literature.     

睾丸微石症的临床研究

目的 认识睾丸微石症(TM)的特点,提高临床诊治水平.方法 回顾性分析15例TM的临床资料,并结合文献进行讨论.结果 所有病例均通过阴囊高频彩超准确诊断,14例患者为双侧睾丸同时存在TM,1例为左侧单发;4例又反复出现睾丸疼痛症状,予以抗炎止痛治疗后好转,其余11例无任何临床症状,均因其他疾病而偶然发现.其中1例患者为...     

Follow-up of testicular microlithiasis for subsequent testicular cancer development

INTRODUCTION: To demonstrate the relationship between testicular microlithiasis and testicular tumor development. PATIENTS AND METHODS: Between January 1996 and March 2004, bilateral testicular microlithiasis was found in 40 of the 5,263 patients who underwent scrotal ultrasonography yielding a prevalence of 0.76%. Of the 40 patients, 4 patients with concomitant testicular tumors were excluded from the study. The remaining 36 patients were enrolled into the study and followed by ultrasonography at 6-month intervals. RESULTS: Patient ages ranged between 1 and 69 years (mean 31 +/- 14 years). The median ultrasonography follow-up was 34 months (range, 1-96). Testicular tumor development was not observed in any of these 36 patients during the follow-up period. CONCLUSIONS: Extensive evaluation including computerized tomography, testicular tumor markers and testicular biopsy of patients with testicular microlithiasis is unnecessary and also increases patient anxiety. Yet annual ultrasonography and physical examination should be performed if ever until testicular microlithiasis is completely accepted as a nonpremalignant disease.     

Clinicopathological study of the testicular microlithiasis

PURPOSE: Testicular microlithiasis (TM) is a relatively rare condition characterized by calcific concref1p4 within the seminiferous tubules. Little has been reported on the incidence or the clinical implication of TM among Japanese. To address the problem, we evaluated pathologic specimens from biopsies and orchiectomies, of testes with various conditions. MATERIALS AND METHODS: Pathologic specimens of the testes of 200 cases, 56 from orchiectomy and 144 from testicular biopsy, were investigated. RESULTS: The pathological diagnosis of TM was confirmed in seven (3.5%) cases, four of which were associated with germ cell tumors and the other three were obtained from testicular biopsies performed for examination of infertile men. Of the 41 patients with germ cell tumors, four (9.8%) were found to have TM, and another three (2.5%) were identified among 122 patients with infertility. The prevalence of TM is significantly higher in specimen with germ cell tumors than those without germ cell tumors (p < 0.05). CONCLUSIONS: Although TM is rarely encountered, this condition is relatively often accompanied by testicular malignancy. Further investigation would be fundamental to ascertain the relationship between TM and testicular malignancy.     

Current management strategies for testicular microlithiasis

The association of testicular microlithiasis with testicular tumor and the management of incidentally detected testicular microlithiasis have generated a great deal of interest. We review the current literature on testicular microlithiasis with regard to its association with testicular tumor. This association seems complex. The available data suggest that men with incidental findings of testicular microlithiasis but who have otherwise normal testes are at low risk of developing testicular cancer. The only follow-up recommended is regular testicular self-examination. Testicular microlithiasis is, however, associated with a high risk of developing testicular malignancy in men with subfertility, history of contralateral testicular tumor or history of cryptorchidism. Regular testicular self-examination is recommended for follow-up of high-risk patients, but the role of surveillance with serial ultrasonography and measurement of tumor markers is still not clear.     

睾丸微结石症对睾丸功能的影响分析

目的了解睾丸微结石症(TM)对睾丸功能的影响,评估TM患者精液质量和血浆性激素水平。方法生育年龄要求生殖健康体检者为对象,通过物理检查,精液分析、生殖系统超声和性激素检查评估睾丸功能,其中诊断TM患者43例,精索静脉曲张(VC)45例和健康人(NC)45例作为对照组。结果本研究TM、VC和NC3组平均年龄分别为(33.25±5.81)岁、(31.85±7.26)岁和(30.13±6.09)岁,3组年龄比较无显著性差异(P>0.05)。TM组睾丸体积、精子密度、活力、活率和血清游离睾酮水平均显著低于NC组(P<0.05),但与VC组比较无显著差异(P>0.05)。结论TM显著影响睾丸功能包括生精功能和睾酮分泌功能,其机制有待于进一步研究。     

Case of mediastinal seminoma with testicular microlithiasis

Testicular microlithiasis is a rare condition in which calcified concretions fill the lumina of the seminiferous tubules. We report the case of a 19-year-old Japanese man with mediastinal seminoma, normal testicular physical findings and bilateral testicular microlithiasis seen on ultrasonography. Testicular needle biopsy demonstrated multiple laminated calcifications within the seminiferous tubules without any signals of a viable germ cell tumor. To our knowledge, this is only the sixth reported case of extragonadal germ cell tumor with testicular microlithiasis.     

睾丸微石症的临床研究进展

随着人们对男性健康意识的提高和超声影像技术不断发展,临床上对睾丸微石症的认识正日益加深。本文就睾丸微石症的概述、病因与发病机制、影像学特点、对男性生殖功能的影响、与睾丸肿瘤及其他相关疾病之间的关系以及治疗、随访等方面,将近年来的研究成果作一总结。由于睾丸微结石症与男性不育、睾丸肿瘤以及身体其他疾病相关,病因、发病机制缺乏深入细致的研究,且尚无特效的治疗方法,仍需要进行充分的探讨,目前研究成果可为临床进一步认识和诊治该病提供一定的参考。     

超声诊断睾丸微石症与睾丸相关疾病的关系研究

目的探讨睾丸微石症(testicular microlithiasis,TM)与睾丸相关疾病的关系。方法回顾性分析6 622例有阴囊症状、经阴囊超声检查发现睾丸微石症(TM)患者的临床资料。结果检出率为3.35%,其中双侧为多,占比为89.1%,TM组与非TM组中睾丸附睾炎的发生率分别为13.45%,14.09%,2组比较P为0.82,x2为0.051,隐睾发生率分别为2.70%,2.37%,2组比较P为0.753,x2为0.098,差异无统计学意义;TM组与非TM组精索静脉曲张发生率分别为49.5%,40.21%,2组比较P为0.0053,x2为7.75,2组差异有统计学意义。结论睾丸微石症发生率不低,其为常见病,其与睾丸附睾炎、隐睾无明确相关关系,而与精索静脉曲张明显相关,超声检查是睾丸微石症确诊和随访的主要工具。     

Testicular microlithiasis and concomitant testicular intraepithelial neoplasia

We report a case of testicular microlithiasis developing during cancer follow-up in a previously normal testicle. Biopsy revealed testicular intraepithelial neoplasia which was treated with radiotherapy. We believe that especially in cancer follow-up newly developing microlithiasis must lead to biopsy to rule out otherwise undetectable germ cell neoplasia precursor.     

Prevalence of testicular microlithiasis in an asymptomatic population

OBJECTIVE: Testicular microlithiasis is a rare, usually asymptomatic, finding of the testes associated with various genetic anomalies and infertility. It is also widely believed that testicular microlithiasis is strongly associated with testicular tumor. The aim of this prospective study was to determine the true prevalence of testicular microlithiasis in an asymptomatic population by means of ultrasound screening. MATERIAL AND METHODS: Healthy male volunteers (17-42 years old) were recruited from the annual Army Reserve Officer Training Corps training camp at Manisa, Turkey. A screening genitourinary history was obtained and a physical examination and screening scrotal ultrasound scan were performed. RESULTS: All men diagnosed with testicular microlithiasis underwent complete clinical evaluations, physical examinations and determination of tumor markers. Fifty-three men with testicular microlithiasis were identified from the 2179 ultrasound scans, giving a prevalence of testicular microlithiasis of 2.4% in this asymptomatic population. The age (mean+/-SD) of subjects with testicular microlithiasis was 23.9+/-4.2 years (range 20-31 years). CONCLUSION: Our results suggest that there is no significant association between TM and testicular cancer, although it is difficult to rule out such an association without further studies with a longer follow-up period.     

Extragonadal seminoma with testicular microlithiasis: a case report

A 43-year-old men presented with left supraclavicular growing mass. Ultrasonography revealed a 31 x 21 mm solid mass with a homogeneous echoic pattern. Lymph node metastasis of some malignant neoplasms was highly suspected. However, whole body evaluation with computed tomographic scan revealed no findings in the primary region. In addition, tumor markers including alpha fetoprotein, human chorionic gonadotropin and carcinoembryonic antigen were within normal limits. Then, extirpation of supraclavicular mass was performed and pathological diagnosis was made as pure seminoma. Evaluation of testicle by ultrasonography revealed a diffuse calcification. However, histological examination of biopsy specimen of testicle revealed no malignancy. The mass was finally diagnosed as extragonadal or "burned-out" pure seminoma. The patient received two courses of Peplomycin, vinblastine and cisplatin (PVP) therapy, and there has been no evidence of recurrence for 34 months.