Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3,477 patients

Miller, Fiona N. A. C.; Rosairo, Shantini; Clarke, Jon; Sriprasad, Seshadri; Muir, Gordon; Sidhu, Paul S.

doi:10.1007/s00330-006-0296-0

Cited by 84 publications

(39 citation statements)

References 38 publications

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“…In healthy men, this prevalence was found to be between 2.4 and 5.6% [21,22]. In children and adolescents referred for testicular US due to any scrotal problem, TM prevalence ranged between 1.1 and 2.0% [23,24,25]. To our knowledge, there are no reported studies investigating TM in patients with CAH.…”

Section: Discussionmentioning

confidence: 87%

“…The co-occurrence of TM with testicular malignancy has been reported to range between 7.5 and 45% in adult patients [9,23]. Leenen and Riebel [24] detected a testicular tumor in 2 of 16 pediatric patients with TM.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors recommend routine US every 6–12 months, others suggest routine US along with the monitoring of tumor markers [6,7,23], while others do not recommend regular US follow-up unless there are other risk factors for developing malignancy [25]. …”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Testicular Microlithiasis in Males with Congenital Adrenal Hyperplasia and Its Association with Testicular Adrenal Rest Tumors

et al. 2010

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Background: Testicular microlithiasis (TM) is characterized by calcium deposits within the seminiferous tubules and is associated with benign and malign conditions. Aim: To determine TM prevalence in patients with congenital adrenal hyperplasia (CAH) and its association with testicular adrenal rest tumors (TART). Patients and Methods: Scrotal ultrasound using a high-frequency linear transducer (12 MHz) was performed in 41 patients aged 12.1 ± 4.7 (range 3.5–23.3) years and 49 healthy similarly aged controls. TM was classified with respect to the number of microliths per ultrasound field as limited (LTM, <5 microliths) and classic (CTM, ≧ 5 microliths). CTM was graded as grade 1 (5–10 microliths), grade 2 (11–20 microliths), and grade 3 (>20 microliths). Results: TM was detected bilaterally in 9 (21.9%) patients and 2 (4.1%) control cases (1 bilateral, 1 unilateral). Four patients had LTM, one evaluated as grade 1, one as grade 2, and three as grade 3. There were 9 patients with TART. Four patients had TM and TART concomitantly. Conclusion: Because TM is frequently found in patients with CAH and may also exist concomitantly with TART, we recommend that these patients be followed annually by testicular ultrasound.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Prevalence of Testicular Microlithiasis in Males with Congenital Adrenal Hyperplasia and Its Association with Testicular Adrenal Rest Tumors

et al. 2010

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“…Testicular microlithiasis (TM), the presence of multiple small deposits of calcium within the testis, shows characteristic sonographic findings of multiple, intratesticular, nonshadowing echogenic foci. Since the original description of ultrasounddetected TM (Doherty et al, 1987), a number of studies have reported an association between TGCT and TM (Backus et al, 1994;Miller et al, 1996Miller et al, , 2006Cast et al, 2000;Bach et al, 2001;Bennett et al, 2001;Derogee et al, 2001;Middleton et al, 2002;Sakamoto et al, 2006). All the studies report ultrasound findings for men investigated for a suspect testicular pathology (infertility, hydrocele, varicocele or suspected tumour) and compare the rate of TM in men found to have TGCT with those that have other diagnoses, including normal testes.…”

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confidence: 99%

Testicular microlithiasis as a familial risk factor for testicular germ cell tumour

et al. 2007

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Testicular microlithiasis (TM) is characterised by small intratesticular calcifications, which can be visualised by ultrasound. Men with testicular germ cell tumour (TGCT) have a higher frequency of TM than men without TGCT. To clarify the association between TGCT and TM and to investigate the relationship between TGCT susceptibility and TM, we recruited TGCT patients with and without family history of TGCT, unaffected male relatives and healthy male controls from the UK. Testicular ultrasound data were analysed from 328 men. Testicular microlithiasis was more frequent in TGCT cases than controls (36.7 vs 17.8%, age adjusted Po0.0001) and in unaffected male relatives than controls (34.5 vs 17.8%, age adjusted P ¼ 0.02). Testicular germ cell tumour case and matched relative pairs showed greater concordance for TM than would be expected by chance (P ¼ 0.05). We show that TM is present at a higher frequency in relatives of TGCT cases than expected by chance indicating that TM is a familial risk factor for TGCT. Although the familiality of TM could be due to shared exposures, it is likely that there exists a genetic susceptibility to TM that also predisposes to TGCT. We suggest that TM is an alternative manifestation of a TGCT susceptibility allele. (Forman et al, 1992;Westergaard et al, 1996;Heimdal et al, 1996a;Sonneveld et al, 1999;Hemminki and Li, 2004), a previously diagnosed germ cell tumour (Osterlind et al, 1991;Wanderas et al, 1997), a history of undescended testis (Brown et al, 1987;Swerdlow et al, 1997), infertility (Petersen et al, 1998;Moller and Skakkebaek, 1999;Jacobsen et al, 2001;Richiardi et al, 2004), atrophy (Harland et al, 1998), and gonadal dysgenesis (Verp and Simpson, 1987). In a proportion of cases (B2%), a first-degree family member is also affected with the disease (Forman et al, 1992). The relative risk to a brother of a TGCT case is 8 -10 (Forman et al, 1992;Heimdal et al, 1996b;Hemminki and Li, 2004), which is higher than for most other cancer types that rarely exceed four (Dong and Hemminki, 2001) and suggests that predisposition genes are important in this disease. However, despite intensive efforts, susceptibility genes are yet to be identified (Crockford et al, 2006). Testicular microlithiasis (TM), the presence of multiple small deposits of calcium within the testis, shows characteristic sonographic findings of multiple, intratesticular, nonshadowing echogenic foci. Since the original description of ultrasounddetected TM (Doherty et al, 1987), a number of studies have reported an association between TGCT and TM (Backus et al, 1994;Miller et al, 1996Miller et al, , 2006Cast et al, 2000;Bach et al, 2001;Bennett et al, 2001;Derogee et al, 2001;Middleton et al, 2002;Sakamoto et al, 2006). All the studies report ultrasound findings for men investigated for a suspect testicular pathology (infertility, hydrocele, varicocele or suspected tumour) and compare the rate of TM in men found to have TGCT with those that have other diagnoses, including normal testes. The studies have shown a hig...

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“…We suggest that NB in the TM group may cause some cases of epididymal cysts, and further study about the association between NB and epididymal cysts will be needed. Other studies have shown an association between testicular tumors and TM (von Eckardstein et al, 2001;Ringdahl et al, 2004;Miller et al, 2007). All patients enrolled in our study were informed about monthly self-examinations.…”

Section: Discussionmentioning

confidence: 99%

Nanobacteria May Be Linked to Testicular Microlithiasis in Infertility

Zhang¹,

Lu²,

Shen³

et al. 2010

Journal of Andrology

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Testicular microlithiasis (TM) in infertility is an uncommon pathologic condition of unclear etiology that is characterized by calcium deposits within the seminiferous tubules. Nanobacteria (NB), as novel microorganisms mediating tissue calcification, have been discovered in some diseases. In this study, we hypothesized that NB may participate in the pathogenesis of TM, particularly in infertility. Seventeen infertility patients with TM detected by scrotal color Doppler ultrasonography and 17 infertility patients without TM as controls were enrolled in the study. The NB were isolated and cultured from semen samples and urine samples. After 3 to 6 weeks of culture, 10 of 17 (58.8%) semen samples and 2 urine samples from infertile patients with TM showed the growth of white granular microbes that firmly attached to the bottom of the culture flask and were visible to the naked eye. In the control group, only 1 of 17 (5.9%) semen samples from infertile patients without TM showed the growth of white granular microbes. The cultured microbes were identified by indirect immunofluorescent staining (IIFS), transmission electron microscopy (TEM), and 16s rRNA gene expression. IIFS and TEM revealed NB to be coccoid and 100 to 500 nm in diameter. The BLAST result revealed that the 16s rRNA gene sequence from the cultured microbes was 97% the same as that of the known NB. Our results showed that NB may be linked to the development of TM, which may provide a potential target for the diagnosis and treatment of infertility with TM.

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Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3,477 patients

Cited by 84 publications

References 38 publications

Prevalence of Testicular Microlithiasis in Males with Congenital Adrenal Hyperplasia and Its Association with Testicular Adrenal Rest Tumors

Prevalence of Testicular Microlithiasis in Males with Congenital Adrenal Hyperplasia and Its Association with Testicular Adrenal Rest Tumors

Testicular microlithiasis as a familial risk factor for testicular germ cell tumour

Nanobacteria May Be Linked to Testicular Microlithiasis in Infertility

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