Testicular microlithiasis: Systematic review and Clinical guidelines.
Fouad Aoun1, Amine Slaoui2, Elias Naoum3
1Service d'Urologie, Institut Jules Bordet, Université Libre de Bruxelles, 1 rue Héger-Bordet, 1000 Brussels, Belgique; Service d'Urologie, Hôtel Dieu de France, Faculté de médecine - Université Saint Joseph, Alfred Naccache boulevard, Beyrouth, Liban.
Summary
Testicular microlithiasis (TM) is linked to testicular germ cell tumors (TGCT). For patients with TM and risk factors, cancer risk is elevated; without risk factors, the risk is similar to the general population.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Lack of clear follow-up guidelines for testicular microlithiasis (TM).
- TM is associated with testicular germ cell tumors (TGCT).
Purpose of the Study:
- To provide clinical guidelines for TM patient follow-up.
- To synthesize evidence on TM and TGCT risk.
Main Methods:
- Systematic review of literature.
- Searched PubMed, Embase, and Cochrane databases (February 2018).
- Used PICOS criteria and PRISMA guidelines for article selection.
Main Results:
- 53 articles synthesized.
- TM presence increases TGCT risk in patients with existing risk factors.
- TM without risk factors shows no increased TGCT risk compared to the general population.
Conclusions:
- Observation vs. biopsy for at-risk patients is debated.
- Recommend individualized approach for TM patients.
- Consider age, testicular dysgenesis syndrome, fertility, paternity desire, and ultrasound patterns.
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