Testicular microlithiasis: prevalence and tumor risk in a population referred for scrotal sonography.

Abstract

OBJECTIVE:

Considerable accrued evidence points to an association between testicular microlithiasis, intratubular germ cell neoplasia, and testicular tumor. This study assesses both the prevalence of testicular microlithiasis revealed on sonography in a referred population and the concurrent tumor risk.

MATERIALS AND METHODS:

Over a 32-month period (April 1996 through November 1998), 4892 scrotal sonographic examinations were performed in 4819 patients at four referral centers. All patients underwent high-resolution (7- to 10-MHz) imaging. Using a computerized word search (n = 4102; testicular microlithiasis, calcification, microliths, calcific foci, tumor, neoplasm, cancer, hyperecho, hypoecho, heterogen, and carcinoma) and manual retrieval (n = 790), cases of tumor, testicular microlithiasis (>5 microliths per sonogram), and testicular microlithiasis plus tumor were pulled and retrospectively reviewed. The presence and type of tumor were confirmed at histology after orchidectomy.

RESULTS:

Fifty-four tumors were found among 4892 scrotal sonograms (28 seminomas, 14 teratomas, 8 mixed germ cell tumors, 2 Leydig cell tumors, and 2 non-Hodgkin's lymphomas). Testicular microlithiasis was present in 33 patients, giving a prevalence of 0.68%. Concurrent tumor and testicular microlithiasis were detected in seven patients, a relative risk of tumor in testicular microlithiasis was 21.6-fold (95% confidence limits: 10. 6-fold, 44.2-fold). In one patient with testicular microlithiasis, a previous orchidectomy for mixed germ cell tumor had been performed (not included in the relative risk calculation).

CONCLUSION:

In a referred population of 4819 patients the prevalence of testicular microlithiasis was 0.68% and the relative risk of concurrent tumor was 21.6-fold. Sonographic surveillance of testicular microlithiasis cases for tumor is mandatory.

• Authors: J E Cast, W M Nelson, A S Early, S Biyani, G Cooksey, N G Warnock, D J Breen
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 175 Issue 6 Pg. 1703-6 (Dec 2000) ISSN: 0361-803X [Print] United States
• PMID: 11090407 (Publication Type: Journal Article)

Topics

• Adult
• Calculi (diagnostic imaging, epidemiology)
• Humans
• Male
• Neoplasms, Germ Cell and Embryonal (epidemiology)
• Prevalence
• Risk Factors
• Scrotum (diagnostic imaging)
• Testicular Diseases (diagnostic imaging, epidemiology)
• Testicular Neoplasms (epidemiology)
• Ultrasonography