Testicular Microlithiasis: cidence In Symptomatic Patients And Its Association With Testicular Cancer

Purpose: To determine prospectively the prevalence of testicular microlithiasis in symptomatic patients who were referred for scrotal ultrasound examination and to evaluate the possible association of testicular microlithiasis with testicular cancer. Material and method: 391 men who were referred to our institution between July 02 and May 05 for any type of symptoms from the testicles underwent clinical examination and scrotal ultrasound examination. The presence of testicular microlithiasis, the number of lesions and the involvement of both testicles in relation to the symptoms and the coexistence of other lesions were studied. Patients found with testicular microlithiasis alone were submitted in biochemical tumour markers examination and placed in annual follow-up with physical examination and ultrasound. Results: Eighteen (4.6%) of 391 men enrolled into the study had testicular microlithiasis. Two out of the eighteen patients (11%) had active testicular cancer which has been confirmed pathologically in the orchiectomy specimen. One of patients with testicular microlithiasis presented a rising in biochemical tumour markers (LDH, and HCG) and underwent orchidectomy one year later. Only five of the rest 373 (1.3%) patients without microlithiasis were found with active testicular cancer. The correlation between testicular cancer and testicular microlithiasis found in our study was confirmed with both parametric and non parametric tests (P<0.001). The most commonly reported symptoms related to the presence of testicular microlithiasis alone were a dull ache or discomfort in the scrotum reported by all patients with testicular microlithiasis alone. Conclusion: There is a possible association of testicular microlithiasis with testicular cancer in symptomatic patients.