Testicular Microlithiasis: Is it a pre-cancerous state?

Backgroud: Testicular microlithiasis (TM) is an uncommon condition characterized by calcium deposits in the lumina of semineferous tubules. These intratesticular calcifications appear as bright 2-3-mm echogenic foci on testicular ultrasound. Cumulated experience points to an association between TM, intratubular germ cell neoplasia and other testicular tumors. Objective: To assess the prevalence of TM revealed on sonography in referred population and its association with the concurrent testicular tumors. Patients and Method: Over a 129-month period (August 1991–May 2002), 2165 high resolution (7.5 MHz) scrotal sonographies were performed in the Imaging Department of Mehr Hospital, a referral center in Tehran. Cases of testicular tumor and TM were selected. The diagnosis and histologic typing of tumors were made by histopathologic studies. Results: A total of 15 cases of TM were discovered, giving a prevalence of 0.7%. Concurrent TM and testicular neoplasia were detected in four patients (27% cases of TM). Conclusion: It is strongly suggested to follow those with TM with physical examination and ultrasonography at least annually and to encourage self-examination.