Testicular Microlithiasis: Prevalence and Risk of Concurrent and Interval Development of Testicular Tumor in a Referred Population

Aims: To identify prevalence of testicular microlithiasis on ultrasound in a referred population and risk of concurrent and interval testicular tumor development.

Methods: Retrospective review of our radiology database revealed 4363 scrotal ultrasounds were performed over a six-year period. Ultrasound findings were correlated with our hospital pathological database. The association of intratesticular microlithiasis and confirmed testicular cancers were assessed by means of a Fisher exact test.

Results: Testicular microlithiasis was identified in 32 of the 4259 patients (0.75% of screened population). In the same time period 83 testicular tumors were identified on initial scanning (2.00% of screened population). Three patients with tumor had coexisting microlithiasis (9.4% incidence), whilst a further two had interval development of tumor. The follow-up of the microlithiasis patients ranged from 3 to 72 months (mean 33.9 months, median 40 months).

Conclusions: Interval development of testicular tumor is a documented phenomenon. As the incidence in detection of microlithiasis increases secondary to advances in ultrasound technology, follow-up becomes financially prohibitive. We advocate regular self-examination as the primary follow-up of otherwise well patients with testicular microlithiasis.