Significance of scrotal calcifications detected by sonography

A total of 468 patients were evaluated using a high-resolution scanner with a high-frequency transducer. Scrotal calcifications were diagnosed by sonographic criteria in 22 patients. Size, number, arrangement, and especially location (testicular or extratesticular) were precisely determined. Calcifications, located within testicular parenchyma, particularly if multiple and grouped, were considered highly suspicious for malignancy, and surgery was mandatory. Based on these sonographic features, 9 patients underwent surgery with pathological examination. In all, calcifications were confirmed and found in 4 necrotic germ-cell tumors, in a germ-cell tumor scar but with intratubular occult seminoma, in 1 epidermoid testicular cyst, in 1 tuberculous epididymo-orchitis, in 1 granulomatous orchitis, and at last, in 1 ruptured testis with an old hematoma. In the 13 remaining patients, calcification was usually defined as solitary, large, and extratesticular by sonography and considered benign. No changes were seen in follow-up examinations.