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Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

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How worrisome is testicular microlithiasis?

Raymond A Costabile¹

¹Urology Department, University of Virginia Health System, Charlottesville, Virginia 22908, USA. rac2b@virginia.edu

Current Opinion in Urology

|October 9, 2007

Summary

Testicular microlithiasis, common in men aged 17-35, rarely leads to testicular cancer. Testicular self-examination is recommended over costly surveillance for those with microcalcifications.

Area of Science:

Urology
Oncology
Radiology

Background:

Anecdotal reports linked testicular microlithiasis (TM) to testicular cancer, raising concerns.
Limited prospective data existed on TM prevalence and natural history in healthy men before 2001.

Purpose of the Study:

To review the relationship between testicular microlithiasis and testicular cancer.
To assess the prevalence and natural history of TM in the general male population.

Main Methods:

Review of existing literature and prospective data up to 2001.
Analysis of prevalence rates in a specific age group and demographic.

Main Results:

Testicular microlithiasis affects 5.6% of men aged 17-35 (14.1% in African Americans), significantly more common than testicular cancer.

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The majority of men with TM do not develop testicular cancer.

Current surveillance methods (ultrasound, tumor markers, biopsy) are costly and offer no improved outcome compared to testicular self-examination.

Conclusions:

Testicular microlithiasis is prevalent, and although microcalcifications are found in about 50% of germ cell tumors, most men with TM will not develop cancer.
Increased emphasis on testicular self-examination is the recommended follow-up for individuals diagnosed with testicular microlithiasis.