Testicular Microlithiasis and Testicular Germ Cell Tumors: A Seven Year Retrospective Study

Testicular Microlithiasis (TM) is an infrequent condition recognized by a sonographic pattern of multiple small foci of increased echogenicity measuring 1-3 mm in diameter. These are randomly distributed throughout the testicular parenchyma, in which calcium deposits have been formed into the lumen of seminiferous tubules or have arisen from the tubular basement membrane components [1-6]. Classic Microlithiasis (CTM) was defined as five or more echogenic foci in either or both testicles and Limited Microlithiasis (LTM) as fewer than five foci [7]. CTM is sub-categorized in grade I (5–10 microliths/image), grade II (10–20 microliths/image), and grade III (> 20 microliths/image) [8]. The incidence of TM on color Doppler ultrasound (US) reported in the literature among symptomatic and asymptomatic patients ranges between 0.6% and 20% [9-17]. TM has been described in association with many benign conditions of the testis, such as testicular torsion, varicocele, epididymitis, and cryptorchidism [10-12,18]. Testicular Germ Cell Tumors (TGCT) is the most frequent malignancies found in Caucasian men between 20 and 40 years old [19]. TGCT represent about 95% of all testicular neoplasias and the worldwide incidence of these tumors has more than doubled over the past 40 years [20,21]. Though most of these tumors are curable, with a current survival index higher than 90%, their occurrence rate is still growing [22,23].