title: Changes of calcific density in pediatric patients with testicular microlithiasis.
abstract: OBJECTIVE
  Testicular microlithiasis (TM) is a relatively rare clinical entity of controversial significance characterized by the existence of hydroxyapatite microliths located in the seminiferous tubules. The aim of this study was to observe the natural course of changes in the calcific density of pediatric TM.
  
  
  METHODS
  We included a total of 23 TM patients undergoing scrotal ultrasound (US) on at least two occasions from July 1997 to August 2014. We retrospectively analyzed the patient characteristics, clinical manifestations, specific pathological features, and clinical outcomes. We measured the calcified area and compared the calcific density between the initial and final USs.
  
  
  RESULTS
  The mean age at diagnosis was 11.3±4.6 years, and the follow-up period was 79.1±38.8 months (range, 25.4-152.9 months). During the follow-up period, no patients developed testicular cancer. Calcific density on US was increased in the last versus the initial US, but not to a statistically significant degree (3.74%±6.0% vs. 3.06%±4.38%, respectively, p=0.147). When we defined groups with increased and decreased calcification, we found that diffuse TM was categorized into the increased group to a greater degree than focal TM (10/20 vs. 4/23, respectively, p=0.049). In addition, five of eight cases of cryptorchidism (including two cases of bilateral cryptorchidism) were categorized in the increased calcification group.
  
  
  CONCLUSIONS
  Diffuse TM and cryptorchidism tend to increase calcific density. Close observation is therefore recommended for cases of TM combined with cryptorchidism and cases of diffuse TM.
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Bumjin
authors: B
authors: Lim
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Sang Hoon
authors: SH
authors: Song
authors: Department of Urology, Kangwon National University Hospital, Chuncheon, Korea.
authors: Geehyun
authors: G
authors: Song
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Kun Suk
authors: KS
authors: Kim
mesh_terms: D000293:Adolescent; D002113:Calcification, Physiologic; D002137:Calculi / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003456:Cryptorchidism / Q000175:diagnosis / Q000209:etiology; D003720:Densitometry / Q000379:methods; D005500:Follow-Up Studies; D018238:Gonadoblastoma / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D056910:Republic of Korea; D012611:Scrotum / Q000000981:diagnostic imaging*; D012671:Seminiferous Tubules / Q000473:pathology*; D013733:Testicular Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014463:Ultrasonography
keywords: Cryptorchidism; Gonadoblastoma; Testicular microlithiasis