title: Incidental discovery of testicular microlithiasis: what is the importance of ultrasound surveillance? Two case reports.
abstract: Many studies have demonstrated an association between diffuse bilateral testicular microlithiasis (TM) and gonadal and extragonadal germ cell tumors. Nevertheless, it is still uncertain whether ultrasound surveillance is really necessary in patients with TM in the absence of other risk factors such as previous testicular cancer, a history of cryptorchidism or testicular atrophy. We report the cases of a 33- and a 39-year-old man presenting with a retroperitoneal extragonadal tumor. The first patient underwent an MRI examination in order to rule out a lumbosacral hernia: MRI images showed no slipped disks but a voluminous retroperitoneal solid mass. The histological analysis revealed an immature teratoma. The second patient came to the emergency department complaining of abdominal pain, vomiting, weight loss and mild jaundice: ultrasound examination showed a large, ill-defined heterogeneous abdominal mass, confirmed by CT and MRI examination. The histology diagnosed a yolk sac tumor. In both patients, the testicular sonography was performed to rule out a focal lesion, but it displayed bilateral TM without a focal testicular mass. Based on our direct experience, we highlight the importance of annual ultrasonographic surveillance of the testis and the retroperitoneal space in patients with occasionally detected TM.
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Barchetti
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: De Marco
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barchetti
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pasqualitto
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sartori
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Glorioso
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gigli
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Megna
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Montechiarello
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Boncore
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Stagnitti
keywords: Germ cell tumors; Testicular microlithiasis; Testicular ultrasound