睾丸微石症2例报告及文献复习

目的:认识睾丸微石症(TM)的临床意义和诊断方法。方法:回顾性报告2例TM病例的临床资料,结合文献进行讨论。结果:2例分别因左精索静脉曲张和附睾炎就诊的患者行阴囊超声检查时发现睾丸内散在多发点状强回声,如针尖样,1～2mm,后无声影。分别诊断为局部TM、左精索静脉曲张和TM,左附睾炎。甲胎蛋白、人绒毛膜促性腺激素、乳酸脱氢酶和睾酮等检查均正常。对睾丸微石症未做特殊处置,随访6～8个月,体检和睾丸瘤标未见异常,阴囊超声睾丸图像无特征性改变。结论:TM是一种少见、无明显临床症状、相对稳定的疾病。多因阴囊其他疾病行超声检查时偶然发现,其是否属于癌前病变尚有争议,但是定期随访和阴囊超声检查是必要的。

Testicular Microlithiasis:A Report of 2 Cases and Review of the Literature

Objective:To investigate the clinical significance and diagnosis of testicular microlithiasis(TM).Methods:We reported 2 cases of TM,reviewed the relevant published literature and analyzed the clinical significance of the condition.Results:Ultrasonographic(US)scanning of the scrota revealed multiple small calcifications diffusely scattered throughout the testicular parenchyma with rare pinpoint-like 1-2 mm shadows but without acoustic ones,which were diagnosed by scrotal sonography as right limited TM and classic TM accompanied with left varicocele and epididymitis.The testicular tumor markers of AFP,hCG,LDH and testosterone were shown to be normal,so that no intervention was performed for TM.During the 6-8 months follow-up,no abnormality was found in physical examinations and testicular tumor markers,and no characteristic additive change was revealed by testicular ultrasound.Conclusion:TM is a rare,usually asymptomatic and non-progressive abnormality,usually detected incidentally during the ultrasound examination of the testis.Though it is still controversial whether TM should be regarded as a premalignant lesion or not,regular follow-up and routine ultrasound examination are quite necessary for TM patients.