Testicular microlithiasis (TM) is an uncommon condition characterized by
calcium deposits within the seminiferous tubules. On ultrasound (US), it is seen as multiple, uniform, nonshadowing echogenic foci in the testis. Although its true prevalence in the general population is still unknown, reported prevalences range from 0.6 to 9%. The TM is often associated with
germ cell tumor (GCT) or intratubular germ cell
neoplasia. The incidence of GCT in patients with TM was reported
as 6-46%. There are several reports demonstrating interval development of GCT in patients with TM. These may suggest a premalignant nature of TM; however, more recent studies show a lower incidence of associated GCT and no interval development of
tumor in relatively longer duration follow-up. Additionally, previously reported cases of interval
tumor development had predisposing factors for testicular GCT. According to the recent literature, it is 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; however, because of a high incidence of association with GCT, it is prudent to follow up patients with TM with physical examination and US at least annually and to encourage self-examination. The routine use of
biochemical tumor markers, abdominal and pelvic CT, or testicular biopsy does not seem to be justified.