Testicular microlithiasis: sonographic and clinical features

Area of Science:

• Urology
• Radiology
• Pathology

Background:

• Testicular microlithiasis (TM) is a condition characterized by the presence of multiple small calcifications within the testes.
• Its association with various testicular and extratesticular conditions necessitates a clear diagnostic approach.

Purpose of the Study:

• To evaluate the sonographic characteristics of bilateral diffuse testicular microlithiasis.
• To determine the diagnostic accuracy of ultrasound in identifying TM and its clinical significance.

Main Methods:

• Retrospective sonographic evaluation of eleven cases with bilateral diffuse testicular microlithiasis.
• Correlation of sonographic findings with clinical data, pathological proof, and follow-up.
• Analysis of associated conditions, including neoplasms, subfertility, and inflammatory processes.

Main Results:

• Testicular microlithiasis was incidentally found in conjunction with testicular neoplasms, abdominal/thoracic malignancies, subfertility, varicocele, epididymitis, testicular maldescent, scrotal trauma, and pain.
• Sonographic findings revealed diffuse hyperechoic, non-shadowing foci (1-2 mm) throughout both testes.
• Pathological confirmation was obtained in five cases; diagnosis was based on sonography, clinical data, and follow-up in others.

Conclusions:

• Testicular microlithiasis is typically asymptomatic and nonprogressive.
• The sonographic appearance of TM is specific, allowing for diagnosis without invasive procedures.
• Biopsy or orchiectomy is deemed unnecessary for diagnosing testicular microlithiasis based on characteristic sonographic findings.