Microcalcifications in testicular malignancy: diagnostic tool in occult tumor?

Malignant testicular tumor microcalcifications are being reported at an increasing rate. However, whether or not the detection of microcalcifications had any clinical significance has not been clarified. In the the present study testicular specimens from 92 patients (43 with malignant and 49 with nonmalignant testicular diseases) were examined postoperatively by mammographic technique. Microcalcifications were identified in 32 of the testicular tumor specimens (74 per cent), more frequently in teratomas (87 per cent) than in seminomas (60 per cent), and in 3 "burned-out" tumors. In contrast, only 8 of the benign testicular specimens showed microcalcifications (16 per cent). The arrangement of microcalcifications as well as the distinct pattern of distribution may further discriminate nonmalignant from malignant entities. Though the rate of detection and allocation of microcalcifications in malignant testicular tumors was a surprising finding, the general use of orchioradiography seems problematic because of the risk of potential damage to the germinal epithelium. In occult carcinoma, however, preoperative or orchioradiography may be justified.