Skip to main content
SpringerLink
Log in

Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3,477 patients

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The prevalence of all forms of scrotal and testicular calcification and their association with testicular tumour in a symptomatic paediatric and adult population was investigated. A retrospective study of all testicular ultrasound examinations performed at a single centre over a 5-year period was undertaken. All studies were performed by experienced operators, recorded in a standard method, using high-frequency linear array transducers (≥10 MHz). All available images (95.2%) were reviewed by experienced operators, recording the location and type of scrotal and testicular calcification according to a pre-determined schedule. A total of 3,854 studies were reviewed on 3,477 patients (age range: 1 month to 91 years). In the adult group, 3,279 examinations were analysed. Prevalence of testicular microlithiasis (TM) was 2.0%, and the prevalence of other non-microlithiasis testicular calcification (non-TM calcification) was 1.7%. Testicular tumour was associated with TM (odds ratio 9.5, P<0.001) and non-TM calcification (odds ratio 11.4, P<0.001) but not with other types of scrotal calcification. A total of 198 paediatric examinations were analysed. Prevalence of TM was 2.0% and the prevalence of non-TM calcification was 0.5%. One tumour (lymphoma) was identified, with no associated calcification. This study confirms the reported association between TM and testicular tumour and finds a previously unreported association between non-TM calcification and testicular tumour.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bushby LH, Miller FNAC, Rosairo S, Clarke JL, Sidhu PS (2002) Scrotal calcification: ultrasound appearances, distribution and aetiology. Br J Radiol 75:283–288

    PubMed  CAS  Google Scholar 

  2. Martin B, Tubiana JM (1988) Significance of scrotal calcification detected by sonography. J Clin Ultrasound 16:545–552

    Article  PubMed  CAS  Google Scholar 

  3. Elzevier HW, Bevers RFM, Wasser MNJM, Pelger RCM (2006) Testis calcification of the tunica albuginea. Euro Radiol 16:240–241

    Article  Google Scholar 

  4. Backus ML, Mack LA, Middleton WD, King BF, Winter TC, True LD (1994) Testicular microlithiasis: imaging appearances and pathologic correlation. Radiology 192:781–785

    PubMed  CAS  Google Scholar 

  5. Vegni-Talluri M, Bigliardi E, Vanni MG, Tota G (1980) Testicular microliths: their origin and structure. J Urol 124:105–107

    PubMed  CAS  Google Scholar 

  6. Hobarth K, Susani M, Szabo N, Kratzik C (1992) Incidence of testicular microlithiasis. Urology 40:464–467

    Article  PubMed  CAS  Google Scholar 

  7. Ganem JP, Workman KR, Shaban SF (1999) Testicular microlithiasis is associated with testicular pathology. Urology 53:209–213

    Article  PubMed  CAS  Google Scholar 

  8. Cast JEI, Nelson WM, Early AS, Biyani S, Cooksey G, Warnock NG et al (2000) Testicular microlithiasis: prevalence and tumor risk in a population referred for scrotal sonography. AJR Am J Roentgenol 175:1703–1706

    PubMed  CAS  Google Scholar 

  9. Skyrme RJ, Fenn NJ, Jones AR, Bowsher WG (2000) Testicular microlithiasis in a UK population: its incidence, associations and follow-up. BJU International 86:482–485

    Article  PubMed  CAS  Google Scholar 

  10. Bach AM, Hann LE, Shi WT, Yoo HH, Giess CS, Sheinfeld J et al (2001) Testicular microlithiasis: what is its association with testicular cancer? Radiology 220:70–75

    PubMed  CAS  Google Scholar 

  11. Otite U, Webb JA, Oliver RT, Badenoch DF, Nargund VH (2001) Testicular microlithiasis; is it a benign condition with malignant potential? Eur Urol 40:538–542

    Article  PubMed  CAS  Google Scholar 

  12. Derogee M, Bevers RF, Prins HJ, Jonges TG, Elbers FH, Boon TA (2001) Testicular microlithiasis, a premalignant condition: prevalent histopathologic findings, and relation to testicular tumor. Urology 57:1133–1137

    Article  PubMed  CAS  Google Scholar 

  13. Peterson AC, Bauman JM, Light DE, McMann LP, Costabile RA (2001) The prevalence of testicular microlithiasis in an asymptomatic population of men 18 to 35 years old. J Urol 166:2061–2064

    Article  PubMed  CAS  Google Scholar 

  14. Middleton WD, Teefey SA, Santillan CS (2002) Testicular microlithiasis: prospective analysis of prevalence and associated tumor. Radiology 224:425–428

    Article  PubMed  Google Scholar 

  15. Leenen A, Riebel T (2002). Testicular microlithiasis in children: sonographic features and clinical implications. Pediatr Radiology 32:575–579

    Article  Google Scholar 

  16. de Gouveia Brazao CA, Pierik FH, Oosterhuis JW, Dohle GR, Looijenga LH, Weber RF (2004) Bilateral testicular microlithiasis predicts the presence of the precursor of testicular germ cell tumors in subfertile men. J Urol 171:158–160

    Article  PubMed  Google Scholar 

  17. Miller FNAC, Sidhu PS (2002) Does testicular microlithiasis matter? A review. Clin Radiol 57:883–890

    Article  PubMed  CAS  Google Scholar 

  18. Grantham JG, Charboneau JW, James EM, Kirschling RJ, Kvols LK, Segura JW et al (1985). Testicular neoplasms: 29 tumors studied by high-resolution US. Radiology 157:775–780

    PubMed  CAS  Google Scholar 

  19. Schwerk WB, Schwerk WN, Rodeck G (1987) Testicular tumours: prospective analysis of real-time US patterns and abdominal staging. Radiology 164:369–374

    PubMed  CAS  Google Scholar 

  20. Woodward PJ, Sohaey R, O’Donoghue MJ, Green DE (2002) Tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics 22:189–216

    PubMed  Google Scholar 

  21. Clarke JL (1999) An evaluation of the scrotal ultrasound service in a major London teaching hospital.MSc Thesis, Southbank University, London

  22. Stata Corporation (2001) STATA Statistical Software. College Station, Texas

  23. Bryan S, Weatherburn G, Buxton M, Watkins J, Keen J, Muris N (1999) Evaluation of a hospital picture archiving and communication system. J Health Serv Res Policy 4:204–209

    PubMed  CAS  Google Scholar 

  24. Comiter CV, Renshaw AA, Benson CB, Loughlin KR (1996) Burned-out primary testicular cancer: sonographic and pathological characteristics. J Urol 156:85–88

    Article  PubMed  CAS  Google Scholar 

  25. Scholz M, Zehender M, Thalmann GN, Borner M, Thoni H, Studer UE (2002) Extragonadal retroperitoneal germ cell tumor: evidence of origin in the testis. Ann Oncol 1:121–124

    Article  Google Scholar 

  26. Lopez JI, Angulo JC (1994) Burned-out tumour of the testis presenting as retroperitoneal choriocarcinoma. Int Urol Nephrol 26:549–553

    PubMed  CAS  Google Scholar 

  27. Cohen EM (1976) Seminoma appearing as a retroperitoneal mass associated with a testicular scar. J Am Osteopath Assoc 75:820–825

    PubMed  CAS  Google Scholar 

  28. Steele RJ (2002) Neoplasia of the testis. In: Walsh PC, Rehk AB, Vaughan D, Wein AJ, Kavoussi LR, Novick AC et al (eds) Campbell’s Urology. Elsevier, London, pp 2879–2880

    Google Scholar 

  29. Coley BD (2005) Resolving testicular microlithiasis in a 12-year-old boy. J Ultrasound Med 24:1445–1448

    PubMed  Google Scholar 

  30. Heinemann V, Frey U, Linke J, Dieckmann KP (2003) Testicular microlithiasis–one case and four points to note. Scand J Urol Nephrol 37:515–518

    Article  PubMed  Google Scholar 

  31. Holm M, Lenz S, De Meyts ER, Skakkebaek NE (2001) Microcalcifications and carcinoma in situ of the testis. BJU International 87:144–149

    Article  PubMed  CAS  Google Scholar 

  32. Hoei-Hansen CE, Rajpert-De Meyts E, Daugaard G, Skakkebaek NE (2005) Carcinoma in situ testis, the progenitor of testicular germ cell tumours: a clinical review. Ann Oncol 16:863–868

    Article  PubMed  CAS  Google Scholar 

  33. von Eckardstein S, Tsakmakidis G, Kamischke A, Rolf C, Nieschlag E (2001) Sonographic testicular microlithiasis as an indicator of premalignant conditions in normal and infertile men. J Androl 22:818–824

    Google Scholar 

  34. Frush DP, Kliewer MA, Madden JF (1996) Testicular microlithiasis and subsequent development of metastatic germ cell tumor. AJR Am J Roentgenol 167:889–890

    PubMed  CAS  Google Scholar 

  35. McEniff N, Doherty F, Katz J, Schrager CA, Klauber G (1995) Yolk sac tumor of the testis discovered on a routine annual sonogram in a boy with testicular microlithiasis. AJR Am J Roentgenol 164:971–972

    PubMed  CAS  Google Scholar 

  36. Winter TC, Zunkel DE, Mack LA (1996) Testicular carcinoma in a patient with previously demonstrated testicular microlithiasis. J Urol 155:648

    Article  PubMed  Google Scholar 

  37. Golash A, Parker J, Ennis O, Jenkins BJ (2000) The interval development of testicular carcinoma in a patient with previously demonstrated testicular microlithiasis. J Urol 163:239

    Article  PubMed  CAS  Google Scholar 

  38. Salisz JA, Goldman KA (1990) Testicular calcification and neoplasia in patients treated for subfertility. Urology 236:557

    Article  Google Scholar 

  39. Barron BA (1977) The effects of misclassification on the estimation of relative risk. Biometrics 33:414–418

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, King’s College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom

    Fiona N. A. C. Miller, Shantini Rosairo, Jane L. Clarke & Paul S. Sidhu

  2. Department of Urology, King’s College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom

    Fiona N. A. C. Miller, Jane L. Clarke, Seshadri Sriprasad & Gordon H. Muir

Authors
  1. Fiona N. A. C. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shantini Rosairo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jane L. Clarke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seshadri Sriprasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gordon H. Muir
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul S. Sidhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul S. Sidhu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miller, F.N.A.C., Rosairo, S., Clarke, J.L. et al. Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3,477 patients. Eur Radiol 17, 363–369 (2007). https://doi.org/10.1007/s00330-006-0296-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-006-0296-0

Keywords

Search

Navigation