Follow-Up of Testicular Microlithiasis for Subsequent Testicular Cancer Development

Abstract

Introduction: To demonstrate the relationship between testicular microlithiasis and testicular tumor development. Patients and Methods: Between January 1996 and March 2004, bilateral testicular microlithiasis was found in 40 of the 5,263 patients who underwent scrotal ultrasonography yielding a prevalence of 0.76%. Of the 40 patients, 4 patients with concomitant testicular tumors were excluded from the study. The remaining 36 patients were enrolled into the study and followed by ultrasonography at 6-month intervals. Results: Patient ages ranged between 1 and 69 years (mean 31 ± 14 years). The median ultrasonography follow-up was 34 months (range, 1–96). Testicular tumor development was not observed in any of these 36 patients during the follow-up period. Conclusions: Extensive evaluation including computerized tomography, testicular tumor markers and testicular biopsyof patients with testicular microlithiasis is unnecessary and also increases patient anxiety. Yet annual ultrasonography and physical examination should be performed if ever until testicular microlithiasis is completely accepted as a nonpremalignant disease.

Grading of Classical Testicular Microlithiasis Has No Effect on the Prevalence of Associated Testicular Tumors

“…To our knowledge, two other studies evaluated the prevalence of CTM in a Turkish population. Pourbarger et al [19] found the prevalence of CTM as 0.76% (40/5,263) in symptomatic and asymptomatic patients with CTM and 10% (4 patients) of those with CTM had concomitant testicular cancer. Furthermore, the authors followed up the remaining 36 patients for 34 months and reported no other testicular cancer development.…”

Association between testicular microlithiasis and primary malignancy of the testis: our experience and review of the literature

“…If confirmed by future prospective studies, this fact should, in our opinion, lead us to suspect the existence of an environment predisposing to the development of testicular cancer and therefore the possibility of identifying the population at risk of such cancer. This hypothesis is not supported by other studies [5,31], and many authors question this association [32][33][34][35][36] and do not recommend monitoring these patients [36]. In our view, the prevalence of retrospective studies on microlithiasis in symptomatic patients, the ongoing technological evolution with the use of high-frequency probes and increasingly sophisticated instruments call for longitudinal prospective studies to shed light on this issue.…”

Testicular microlithiasis an ultrasound dilemma: survey of opinions regarding significance and management amongst UK ultrasound practitioners

“…Five of these studies did not show interval development of TGCT. [17][18][19][20][21] In 3 studies, interval development of TGCT was documented. In the first study, 63 males were screened with ultrasound and 1 developed a TGCT at 5-year follow-up, 22 and in the other 2 prospective studies, 3 patients developed interval tumours; however, all had co-existing risk factors for TGCT.…”