How worrisome is testicular microlithiasis?
OBJECTIVE
Anecdotal reports of men developing testicular cancer after previous identification of microcalcifications on ultrasound generated significant concern in the literature about the relationship of testicular microlithiasis and testis cancer. Until 2001 little prospective data were available on the prevalence or natural history of testicular microlithiasis in the healthy male population.


RESULTS
Testicular microlithiasis is present in 5.6% of the male population between 17 and 35 years of age (14.1% in African Americans), far more common than testicular cancer (7:100,000). The majority of men with testicular microlithiasis will not develop testicular cancer. Previously recommended surveillance regimens using ultrasound, tumor markers or testicular biopsy are too costly and do not offer an improved outcome over testicular self-examination.


CONCLUSIONS
Testicular microlithiasis is common and while microcalcifications do exist in roughly 50% of germ cell tumors the majority of men with testicular microlithiasis will not develop testicular cancer. Increased emphasis on testicular examination is the recommended follow up for men identified with testicular microlithiasis.
Costabile
Raymond A
RA
Urology Department, University of Virginia Health System, Charlottesville, Virginia 22908, USA. rac2b@virginia.edu
D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D006801:Humans; D020347:Lithiasis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016353:Self-Examination; D013733:Testicular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013737:Testis / Q000000981:diagnostic imaging; D014463:Ultrasonography