title: Ultrasound demonstration of testicular microlithiasis in pediatric patients: is there an association with testicular germ cell tumors?
abstract: BACKGROUND
  There is suggestion that testicular microlithiasis predicts risk of testicular malignancy, especially testicular germ cell tumors. This association remains uncertain.
  
  
  OBJECTIVE
  We retrospectively reviewed testicular germ cell tumor occurrence in patients with testicular microlithiasis to assess this association and determined the prevalence of testicular microlithiasis in symptomatic boys.
  
  
  METHODS
  This study was IRB and HIPAA compliant. Two-thousand six-hundred twenty-five testicular US exams performed on 2,266 children (younger than 19 years of age) in our institution from 2000 through 2011 were reviewed for presence of testicular microlithiasis and masses. Testicular microlithiasis was defined as presence of five or more testicular microcalcifications on a single US image. Incidence of testicular germ cell tumors was calculated in a group of patients with testicular microlithiasis and in a control group without testicular microlithiasis. Relative risk, odds ratio, 90% and 95%CI were calculated.
  
  
  RESULTS
  Eighty-seven patients out of 2,266 had testicular microlithiasis. One child was found to have both testicular germ cell tumor and testicular microlithiasis. In 2,179 children without testicular microlithiasis, 8 had testicular germ cell tumors. Incidence of testicular microlithiasis was 3.8%. Incidence of testicular germ cell tumors in testicular microlithiasis patients was 1.2%, and 0.38% in non-testicular microlithiasis patients. Relative risk of testicular germ cell tumors in testicular microlithiasis patients vs. non-testicular microlithiasis patients was 3.13 (90%CI: 0.55-17.76; 95%CI: 0.40-24.76), odds ratio 3.16 (90%CI: 0.55-18.32; 95%CI: 0.39-25.5).
  
  
  CONCLUSIONS
  There is no association between testicular microlithiasis and testicular germ cell tumors. We had hoped to do a meta-analysis, but only two studies had a sufficient case control group of non-testicular microlithiasis patients.
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Schuman Pavilion, Room 2605-E, Loma Linda, CA, 92354, USA, yvolokhina@llu.edu.
authors.forename: Yulia V
authors.initials: YV
authors.lastname: Volokhina
authors.forename: Udochukwu E
authors.initials: UE
authors.lastname: Oyoyo
authors.forename: John H
authors.initials: JH
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D002137:Calculi / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013733:Testicular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data*; D055815:Young Adult
references.citation: J Urol. 1979 Apr;121(4):535-7
references.pmid: 35622
references.citation: J Urol. 2009 Oct;182(4):1516-20
references.pmid: 19683752
references.citation: Acta Cir Bras. 2011 Oct;26(5):387-90
references.pmid: 21952663
references.citation: J Endocrinol Invest. 2006 Jan;29(1):82-5
references.pmid: 16553039
references.citation: J Urol. 1998 Sep;160(3 Pt 2):1151-4; discussion 1178
references.pmid: 9719297
references.citation: Pediatr Radiol. 2002 Aug;32(8):575-9
references.pmid: 12136348
references.citation: AJR Am J Roentgenol. 1995 Apr;164(4):971-2
references.pmid: 7726059
references.citation: BJU Int. 2007 Jan;99(1):157-60
references.pmid: 17026598
references.citation: Urology. 2009 May;73(5):1029-31
references.pmid: 19100602
references.citation: J Pediatr Urol. 2012 Apr;8(2):162-5
references.pmid: 21546312
references.citation: Urol J. 2011 Fall;8(4):287-90
references.pmid: 22090047
references.citation: Korean J Urol. 2011 Mar;52(3):172-7
references.pmid: 21461280
references.citation: Cancer. 2010 Oct 1;116(19):4520-32
references.pmid: 20578177
references.citation: J Paediatr Child Health. 2014 Oct;50(10):E102-5
references.pmid: 21392148
references.citation: J Pediatr Urol. 2012 Oct;8(5):459-69
references.pmid: 21856234
references.citation: Diagn Interv Radiol. 2005 Mar;11(1):60-5
references.pmid: 15795846
references.citation: Eur Radiol. 1999;9(5):940-4
references.pmid: 10369996