title: Long-Term Follow-Up of Testicular Microlithiasis in Children and Adolescents: Multicenter Prospective Cohort Study of the Italian Society of Pediatric Urology.
abstract: IntroductionTesticular microlithiasis (TM), characterized by the presence of intratubular calcifications in a single or both the gonads, is an uncommon entity with unknown etiology and outcome in pediatric and adolescent age. In this study, the results of a multicenter long-term survey are presented.Materials and MethodsFrom 11 units of pediatric urology/surgery, patients with TM were identified and yearly, followed up in a 7-year period, adopting a specific database. The recorded items were: age at diagnosis, presenting symptoms/associated abnormalities, ultrasonographic finding, surgery and histology at biopsy, if performed.ResultsOut of 85 patients, 81 were evaluated yearly (4 patients lost to follow-up). TM was bilateral in 66.6% of the patients. Associate genital abnormalities were present in 90%, more frequently undescended/retractile testis (23.4%) and varicocele (22.2%). TM remained unchanged at 4.7 years follow-up in 77 patients (93.8%) and was reduced in 4 patients after 1 to 5 years of inguinoscrotal surgery. Orchiectomy was performed in three patients (3.7%), one for severe testicular hypoplasia and two for seminoma (2.5%), respectively, concurrent and metachronous to diagnosis of TM. Tumorectomy with parenchymal sparing surgery was performed in a teratoma associated with TM.ConclusionTM is a controversial entity, often associated with several inguinogenital features, which rarely can recover. Testicular malignancy, although present in TM, has not proven definitively associated to microliths. Proper counseling, yearly ultrasound, and self-examination are long-term recommended.
authors.affiliation: Division of Pediatric Surgery, Second University of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marte
authors.affiliation: Division of Pediatric Surgery, Second University of Naples, Naples, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pintozzi
authors.affiliation: Division of Pediatric Urology, "Casa Sollievo della Sofferenza" Hospital, IRCCS-San Giovanni Rotondo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cretì
authors.affiliation: Division Pediatric Surgery, "Santo Spirito" Hospital-G. D'Annunzio University-Chieti-Pescara, Pescara, Italy.
authors.forename: Pierluigi Lelli
authors.initials: PL
authors.lastname: Chiesa
authors.affiliation: Division Pediatric Surgery, "Santo Spirito" Hospital-G. D'Annunzio University-Chieti-Pescara, Pescara, Italy.
authors.forename: Dacia Di
authors.initials: DD
authors.lastname: Renzo
authors.affiliation: Division of Pediatric Surgery, Hospital of Treviso-Padua University, Treviso, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gasparella
authors.affiliation: Department of Medical Sciences, Surgery and Neuroscience, Siena University, Siena, Italy.
authors.forename: Giovanni Di
authors.initials: GD
authors.lastname: Maggio
authors.affiliation: Unit of Pediatric Surgery, "G.B. Morgagni" Hospital, Catania, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnara
authors.affiliation: Division of Pediatric Urology, S. Anna Hospital, Torino, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Merlini
authors.affiliation: Division of Pediatric Urology, S. Anna Hospital, Torino, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tadini
authors.affiliation: Division of Pediatric Surgery OO.RR., Hospital of Foggia, Foggia, Italy.
authors.forename: Eustachio
authors.initials: E
authors.lastname: Caldarulo
authors.affiliation: Unit Pediatric Urology, "SS. Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Sangiorgio
authors.affiliation: Division of Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Battaglino
authors.affiliation: Division of Pediatric Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Simona Gerocarni
authors.initials: SG
authors.lastname: Nappo
authors.affiliation: Division of Pediatric Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Caione
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002137:Calculi / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D020347:Lithiasis; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000000981:diagnostic imaging; D015995:Prevalence; D011446:Prospective Studies; D013733:Testicular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D013736:Testicular Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D014463:Ultrasonography