Testicular microlithiasis: unusual ultrasound finding
Silvani, M.; Bossola, P.C.; Pagani, G.; Minocci, D.
Archivio Italiano di Urologia Andrologia Organo Ufficiale di Societa Italiana di Ecografia Urologica e Nefrologica 74(4): 238-240
2002
ISSN/ISBN: 1124-3562 PMID: 12508737 Document Number: 548440
In our work we evaluate the incidence of testicular microlithiasis (TM) on more than 500 scrotal echoes we performed in our hospital in a period of three years, from 1998 to 2001. Ultrasound sonography (USS) was performed by a 5.5-7.5 double scanned Mhz probe (Ansaldo AU 560 degrees). We found only 2 cases of TM (0.4%); our percentage of such pathology is lower when compared to percentages we can find in literature. In only one case we performed a testicular biopsy, because the patient had teratospermia; we found intra tubular seminific calcification associated with haematoxilim positive bodies. Testicular microlithiasis has an echographic characteristic appearance, more than a clinical pathological issue. Referred literature shows how this pathology can be associated with criptorchidysm (20%) and can correlate (40%) with probability of clinical evolution in testicular malign neoplasms, mainly germinal ones. This pathology is characteristic in its showing multiple microcalcification, (not less than for testis), 1-3 mm in diameter and not always regularly distributed in testis parenchyma. Often associated with testicular microlithiasis is dyspermia. In patients in which microlithiasis of the testis is diagnosed, USS and bio-humoral follow-up is of major importance. Literature shows how high can be the risk that this pathology can evolve to germinal tumor. It must be recommended regular evaluation of alpha-fetoprotein, beta chronic gonadotropin. USS must be performed almost once a year. Biopsy is rarely suggested, and only in case of teratospermia. At the moment no therapy is referred.