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Testiculaire microlithiasis bij jongens

  • Casuïstische mededelingen
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Tijdschrift voor Kindergeneeskunde

Samenvatting

Bij drie jongens van respectievelijk 15, 9 en 10 jaar werd door middel van echografie de diagnose testiculaire microlithiasis (TM) gesteld. Twee van hen hadden geen klachten, één klaagde over pijn in de testis. TM wordt gekenmerkt door meerdere echorijke foci in de tubuli seminiferi zonder slagschaduw. De oorzaak is grotendeels onbekend. Bij volwassenen bedraagt de prevalentie tussen de 0,2 en 29%, bij jongens tussen de 0,1 en 11,7%. Er zijn aanwijzingen dat TM geassocieerd is met maligne aandoeningen van de testis. Alhoewel er bij volwassenen geen eensluidende richtlijn voor follow-up bestaat, wordt veelal jaarlijkse follow-up geadviseerd. Voor jongens bestaan vrijwel geen richtlijnen. Een driemaandelijks zelfonderzoek gecombineerd met jaarlijks lichamelijk onderzoek en echografie is raadzaam, vooral bij jongens met een al verhoogd risico op testismaligniteiten zoals jongens met een niet-scrotale testis. De prognose, evenzeer ten aanzien van de fertiliteit, is grotendeels onbekend.

Summary

In three boys aged 15, 9, and 10 years respectively scrotal ultrasound revealed testicular microlithiasis (TM). Two boys were free of symptoms and one suffered from testicular pain. TM is characterized by multiple echogenic foci within the seminiferous tubules with no acoustic shadowing. The pathophysiology is largely unknown. In adult men, TM prevalence has been reported to range from 0.2 to 29%. In boys the prevalence rate varies from 0.1 to 11.7%. There are indications that TM might be associated with malignant conditions of the testes. Although in adult men the method of follow-up is controversial, annual follow-up is usually recommended. In pediatric patients virtually no follow-up guidelines exist. Testicular self-examination, for example three monthly, and annual ultrasound in addition to physical examination might be warranted especially in boys with undescended testis who are already at risk for malignant transformation in the cryptorchid testis. Prognosis, as well as with regard to fertility, is largely unknown.

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    W. W. M. Hack

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  1. W. W. M. Hack
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  2. J. Goede
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  3. P. R. Algra
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  4. F. H. Pierik
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Correspondence to W. W. M. Hack.

Additional information

Dhr. J. Goede, arts-assistent, dhr. dr. W.W.M. Hack, kinderarts, afdeling Kindergeneeskunde; dhr. dr. P.R. Algra, radioloog, afdeling Radiologie, Medisch Centrum Alkmaar. Dhr.?dr. F.H. Pierik, gezondheidswetenschapper, afdeling Leefomgeving en Gezondheid, TNO, Delft.

Correspondentieadres: Dr. W.W.M. Hack, afdeling Kindergeneeskunde, Medisch Centrum Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, tel: 072-5484444, fax: 072-5482190,

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Hack, W.W.M., Goede, J., Algra, P.R. et al. Testiculaire microlithiasis bij jongens. KIND 76, 34–38 (2008). https://doi.org/10.1007/BF03078173

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