Abstract
Background
There is suggestion that testicular microlithiasis predicts risk of testicular malignancy, especially testicular germ cell tumors. This association remains uncertain.
Objective
We retrospectively reviewed testicular germ cell tumor occurrence in patients with testicular microlithiasis to assess this association and determined the prevalence of testicular microlithiasis in symptomatic boys.
Materials and methods
This study was IRB and HIPAA compliant. Two-thousand six-hundred twenty-five testicular US exams performed on 2,266 children (younger than 19 years of age) in our institution from 2000 through 2011 were reviewed for presence of testicular microlithiasis and masses. Testicular microlithiasis was defined as presence of five or more testicular microcalcifications on a single US image. Incidence of testicular germ cell tumors was calculated in a group of patients with testicular microlithiasis and in a control group without testicular microlithiasis. Relative risk, odds ratio, 90% and 95%CI were calculated.
Results
Eighty-seven patients out of 2,266 had testicular microlithiasis. One child was found to have both testicular germ cell tumor and testicular microlithiasis. In 2,179 children without testicular microlithiasis, 8 had testicular germ cell tumors. Incidence of testicular microlithiasis was 3.8%. Incidence of testicular germ cell tumors in testicular microlithiasis patients was 1.2%, and 0.38% in non-testicular microlithiasis patients. Relative risk of testicular germ cell tumors in testicular microlithiasis patients vs. non-testicular microlithiasis patients was 3.13 (90%CI: 0.55–17.76; 95%CI: 0.40–24.76), odds ratio 3.16 (90%CI: 0.55–18.32; 95%CI: 0.39–25.5).
Conclusion
There is no association between testicular microlithiasis and testicular germ cell tumors. We had hoped to do a meta-analysis, but only two studies had a sufficient case control group of non-testicular microlithiasis patients.
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References
Tan IB, Ang KK et al (2010) Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer 116:4520–4532
Dutra RA, Perez-Boscollo AC et al (2011) Clinical importance and prevalence of testicular microlithiasis in pediatric patients. Acta Cir Bras 26:387–390
Yee WS, Kim YS, Kim SJ et al (2011) Testicular microlithiasis: prevalence and clinical significance in a population referred for scrotal ultrasonography. Korean J Urol 52:172–177
Leenen AS, Riebel TW (2002) Testicular microlithiasis in children: sonographic features and clinical implications. Pediatr Radiol 32:575–579
Arrigo T, Messina MF, Valenzise M et al (2006) Testicular microlithiasis heralding mixed germ cell tumor of the testis in a boy. J Endocrinol Invest 29:82–85
Price NR, Charlton A, Simango I et al (2011) Testicular microlithiasis: the importance of self-examination. J Paediatr Child Health. doi:10.1111/j.1440-1754.2011.02021.x [Epub ahead of print]
Slaughenhoupt B, Kadlec A, Schrepferman C (2009) Testicular microlithiasis preceding metastatic mixed germ cell tumor—first pediatric report and recommended management of testicular microlithiasis in the pediatric population. Urology 73:1029–1031
Goede J, Hack WW, van der Voort-Doedens LM et al (2009) Prevalence of testicular microlithiasis in asymptomatic males 0 to 19 years old. J Urol 182:1516–1520
Chiang LW, Yap TL, Asiri MM et al (2011) Implications of incidental finding of testicular microlithiasis in paediatric patients. J Pediatr Urol 8:162–165
Kocaoglu M, Bozlar U, Bulakbasi N et al (2005) Testicular microlithiasis in pediatric age group: ultrasonography findings and literature review. Diagn Interv Radiol 11:60–65
Silveri M, Bassani F, Colajacomo M et al (2011) Management and follow-up of pediatric asymptomatic testicular microlithiasis: are we doing it well? Urol J 8:287–290
Dell’Acqua A, Toma P, Oddone M et al (1999) Testicular microlithiasis: US findings in six pediatric cases and literature review. Eur Radiol 9:940–944
Furness PD 3rd, Husmann DA, Brock JW 3rd et al (1998) Multi-institutional study of testicular microlithiasis in childhood: a benign or premalignant condition? J Urol 160:1151–1154, discussion 1178
Nistal M, Paniagua R, Diez-Pardo JA (1979) Testicular microlithiasis in 2 children with bilateral cryptorchidism. J Urol 121:535–537
Dagash H, Mackinnon EA (2007) Testicular microlithiasis: what does it mean clinically? BJU Int 99:157–160
McEniff N, Doherty F, Katz J et al (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
Goede J, Hack WW (2011) Clinical aspects of testicular microlithiasis in boys: a review. J Pediatr Urol 8:459–469
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Volokhina, Y.V., Oyoyo, U.E. & Miller, J.H. Ultrasound demonstration of testicular microlithiasis in pediatric patients: is there an association with testicular germ cell tumors?. Pediatr Radiol 44, 50–55 (2014). https://doi.org/10.1007/s00247-013-2778-y
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DOI: https://doi.org/10.1007/s00247-013-2778-y