Testicular Mass with Macrocalcification and Osseous Metaplasia: A Case Report

Overview

Journal SAGE Open Med Case Rep

Publisher Sage Publications

Specialty General Medicine

Date 2024 Aug 20

PMID 39161920

Authors

Masoumeh Pourjabali

Masoumeh Noushyar

Ali Ghahramanpour

Fatemeh Mansouri

Affiliations

Soon will be listed here.

Abstract

Testicular calcification is caused by calcium deposits of the testis in men with controversial and unknown etiology. Calcifications with a size >3 mm are considered as macrocalcifications. Calcifications are the result of high local calcium concentrations in many tissues. Ultrasonography is the gold standard imaging tool for testis investigation. We report a 28-year-old man who presented with left testicular pain and an inguinal hernia from 1 year ago. The ultrasonography demonstrated a hypoechoic calcified region size of 12 × 18 mm. The tumor markers were negative. After radical orchiectomy, the histopathology showed testicular calcification with benign osseous metaplasia. Calcification within a testis is found incidentally using ultrasonography since it may be misdiagnosed as a small benign or malignant mass.

References

Lotti F, Maggi M . Ultrasound of the male genital tract in relation to male reproductive health. Hum Reprod Update. 2014; 21(1):56-83. DOI: 10.1093/humupd/dmu042. View

Pedersen M, Moller H, Rafaelsen S, Jorgensen M, Osther P, Vedsted P . Characteristics of symptomatic men with testicular microlithiasis - A Danish cross-sectional questionnaire study. Andrology. 2017; 5(3):556-561. PMC: 6088230. DOI: 10.1111/andr.12326. View

Akdemir F, Aldemir M, Orhun H . Intratesticular calcified nodule. Turk J Urol. 2017; 43(4):563-565. PMC: 5687227. DOI: 10.5152/tud.2017.94580. View

Frandsen R, Durukan E, von Rohden E, Jensen C, Thamsborg A, Azawi N . Testicular biopsies in men with testicular microlithiasis and additional risk factors for cancer: A case series. Andrology. 2024; 12(8):1764-1770. DOI: 10.1111/andr.13610. View

Pedersen M, Bartlett E, Brown C, Rafaelsen S, Sellars M, Sidhu P . Is Testicular Macrocalcification a Risk for Malignancy?: Tumor Development on Ultrasonographic Follow-up of Preexisting Intratesticular Macrocalcification. J Ultrasound Med. 2018; 37(12):2949-2953. DOI: 10.1002/jum.14657. View

Goede J, Hack W, van der Voort-Doedens L, Sijstermans K, Pierik F . Prevalence of testicular microlithiasis in asymptomatic males 0 to 19 years old. J Urol. 2009; 182(4):1516-20. DOI: 10.1016/j.juro.2009.06.065. View

Goel R, Norman R, Gupta R . Dystrophic calcified nodule of the testicle: a case report. Can Urol Assoc J. 2008; 1(4):402-3. PMC: 2422998. DOI: 10.5489/cuaj.457. View

Gerber D, Wright H, Sussman R, Stamatakis L . Embryonal carcinoma presenting as a calcified solitary testicular mass on ultrasound. BMJ Case Rep. 2017; 2017. PMC: 5613830. DOI: 10.1136/bcr-2017-220081. View

Accardo G, Vallone G, Esposito D, Barbato F, Renzullo A, Conzo G . Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients. Asian J Androl. 2014; 17(1):154-8. PMC: 4291860. DOI: 10.4103/1008-682X.128514. View

10.

Betancourt Sevilla M, Granda Gonzalez D . Association between testicular cancer and microlithiasis. Actas Urol Esp (Engl Ed). 2022; 46(10):587-599. DOI: 10.1016/j.acuroe.2022.07.002. View

11.

Balawender K, Orkisz S, Wisz P . Testicular microlithiasis: what urologists should know. A review of the current literature. Cent European J Urol. 2018; 71(3):310-314. PMC: 6202617. DOI: 10.5173/ceju.2018.1728. View

12.

Hiramatsu I, Tsujimura A, Miyoshi M, Ogasa T, Miyoshi Y, Ishikawa K . Prevalence of testicular microlithiasis in healthy newlywed men trying for first-time pregnancy. Int J Urol. 2020; 27(11):990-995. DOI: 10.1111/iju.14342. View

13.

Pedersen M, Rafaelsen S, Moller H, Vedsted P, Osther P . Testicular microlithiasis and testicular cancer: review of the literature. Int Urol Nephrol. 2016; 48(7):1079-86. DOI: 10.1007/s11255-016-1267-2. View

14.

Winter T, Kim B, Lowrance W, Middleton W . Testicular Microlithiasis: What Should You Recommend?. AJR Am J Roentgenol. 2016; 206(6):1164-9. DOI: 10.2214/AJR.15.15226. View

15.

Lotti F, Frizza F, Balercia G, Barbonetti A, Behre H, Calogero A . The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Scrotal ultrasound reference ranges and associations with clinical, seminal, and biochemical characteristics. Andrology. 2020; 9(2):559-576. DOI: 10.1111/andr.12951. View

16.

Migliorini F, Baldassarre R, Artibani W, Martignoni G, Brunelli M . Rare case of intra-testicular adenomatoid tumour. Arch Ital Urol Androl. 2014; 86(1):44-5. DOI: 10.4081/aiua.2014.1.44. View

17.

Robbins M, Stokes J, Craig L . Pathology in Practice. J Am Vet Med Assoc. 2018; 252(8):941-943. DOI: 10.2460/javma.252.8.941. View

18.

de Gouveia Brazao C, Pierik F, Oosterhuis J, Dohle G, Looijenga L, Weber R . Bilateral testicular microlithiasis predicts the presence of the precursor of testicular germ cell tumors in subfertile men. J Urol. 2003; 171(1):158-60. DOI: 10.1097/01.ju.0000093440.47816.88. View

19.

Anract J, Baures M, Barry Delongchamps N, Capiod T . Microcalcifications, calcium-sensing receptor, and cancer. Cell Calcium. 2019; 82:102051. DOI: 10.1016/j.ceca.2019.06.005. View

20.

Lotti F, Bertolotto M, Maggi M . Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal. Andrology. 2021; 9(5):1331-1355. DOI: 10.1111/andr.13062. View