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Testicular microlithiasis in children: sonographic features and clinical implications
Andreas S Leenen1, Thomas W Riebel
1Department of Paediatric Radiology, Charité, Humboldt University, Berlin, Germany. a.leenen@t-online.de
Background:
The natural history of incidentally discovered testicular microlithiasis in children has not been well defined. Although a benign condition, this entity has been found to be associated with testicular malignancies.
Objective:
To determine the spectrum of sonographic findings and clinical implications in children with testicular microlithiasis.
Materials And Methods:
During a 3.5-year period, 850 scrotal examinations with grey-scale US detected testicular microlithiasis in 16 boys (1.9%), age range 6-18 years. The US records of these patients were retrospectively analysed for distribution and pattern of this finding. The presence of intratesticular pathology was determined and the medical records and pathological reports were reviewed. In five patients, US re-evaluation up to 6 years could be performed.
Results:
Typical punctate hyperechoic foci were found bilaterally in all cases except five, which showed only unilateral foci. Additional pathology was depicted in four patients (chorioncarcinoma n=1; a cystic lesion in a patient with a large-cell calcifying Sertoli-cell tumour, n=1; diffuse structural alterations after orchidopexy, n=2). No testicular tumour developed during clinical follow-up.
Conclusions:
The association with benign and malignant testicular tumours, as described in adults, also seems valid in the paediatric age group. Therefore, children with testicular microlithiasis should have clinical and US long-term follow-up.
Insights
Pediatric testicular microlithiasis, a rare finding on ultrasound, may be linked to testicular tumors. Long-term clinical and ultrasound follow-up is recommended for affected children.
Area of Science:
- Pediatric Radiology
- Urologic Oncology
- Pediatric Urology
Background:
- The natural history of incidentally discovered testicular microlithiasis in children is not well-defined.
- Testicular microlithiasis, though generally benign, has been associated with testicular malignancies.
Purpose of the Study:
- To determine the spectrum of sonographic findings in children with testicular microlithiasis.
- To evaluate the clinical implications of testicular microlithiasis in pediatric patients.
Main Methods:
- Retrospective analysis of scrotal ultrasound examinations over 3.5 years.
- Identification of 16 boys (1.9%) with testicular microlithiasis (age 6-18 years).
- Review of medical records and pathological reports for associated pathologies; ultrasound re-evaluation in 5 patients up to 6 years.
Main Results:
- Punctate hyperechoic foci were bilateral in most cases; five showed unilateral foci.
- Four patients had additional pathologies, including chorioncarcinoma and a Sertoli-cell tumor.
- No testicular tumors developed during the clinical follow-up period.
Conclusions:
- The association between testicular microlithiasis and testicular tumors, observed in adults, appears relevant in the pediatric age group.
- Children diagnosed with testicular microlithiasis warrant long-term clinical and ultrasound surveillance.