title: Testicular microlithiasis--one case and four points to note.
abstract: A 38-year-old man with non-specific scrotal complaints was found to have bilateral testicular microlithiasis (TM) sonographically. MRI of the testes failed to depict microlithiasis. Bilateral double biopsies of the testes revealed testicular intraepithelial neoplasia (TIN; carcinoma in situ of the testis) in only one of the two biopsies from the right testis. At the request of the patient the biopsies were repeated, with the same histological result. A right-sided orchiectomy was performed. Histology disclosed TIN in only some tubules of the lower pole of the testis. This case highlights four interesting points: (i) TM may be associated with testicular malignancy; (ii) MRI does not depict TM; (iii) TIN is arranged focally within the testis; and (iv) a two-site biopsy may increase the sensitivity of the diagnosis of TIN.
authors.affiliation: Urologische Abteilung, Albertinen-Krankenhaus, Hamburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Heinemann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frey
authors.forename: Jörg
authors.initials: J
authors.lastname: Linke
authors.forename: K-P
authors.initials: KP
authors.lastname: Dieckmann
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D002278:Carcinoma in Situ / Q000473:pathology*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D020347:Lithiasis / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009919:Orchiectomy / Q000379:methods; D018570:Risk Assessment; D013733:Testicular Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D013736:Testicular Neoplasms / Q000473:pathology*; D014463:Ultrasonography