[Intratesticular calcifications in childhood]

Area of Science:

• Pediatric Radiology
• Urologic Imaging

Background:

• Testicular microlithiasis (TM) is an uncommon pediatric finding, with incidence rates between 0.16-0.6%.
• Increased use of high-frequency ultrasound has led to more incidental TM diagnoses.

Purpose of the Study:

• Evaluate sonographic patterns of TM in children.
• Assess associations, clinical consequences, and management of pediatric TM.
• Determine the relationship between TM and testicular cancer in pediatric patients.

Main Methods:

• Retrospective analysis of seven pediatric patients diagnosed with TM between 1998-2002.
• Sonographic evaluation characterized by hyperechogenic foci (1-3 mm) without acoustic shadowing.
• Annual clinical and radiological follow-up for 18 months to 6 years.

Main Results:

• All seven children were asymptomatic; ultrasounds were performed for other conditions like cryptorchidism, short stature, gynecomastia, varicocele, or scrotal trauma.
• Three cases showed bilateral TM; 8 out of 10 affected testicles met criteria for classic TM (CTM), and 2 for limited TM (LTM).
• No progression or regression in TM number or distribution was observed during follow-up. No testicular cancer was diagnosed in any patient.

Conclusions:

• While TM is not considered a premalignant lesion, an association with testicular cancer exists.
• Annual clinical and ultrasound follow-up is recommended until puberty.
• Biopsies are not advised unless echogenicity changes or TM distribution/number alters significantly.