The Prevalence of Testicular Microlithiasis in an Asymptomatic Population of Men 18 to 35 Years Old

Peterson, Andrew C.; Bauman, John M.; Light, Dawn; McMann, Leah P.; Costabile, Raymond A.

doi:10.1016/s0022-5347(05)65506-1

Cited by 192 publications

(70 citation statements)

References 30 publications

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“…The remainder of the control group was derived from volunteers. As demonstrated, the overall rate of CTM among healthy controls in our study is similar to that reported previously (Peterson et al, 2001;Serter et al, 2006). Furthermore, there was no difference in the rate of TM reported between the two control sources (8/57 (14%) vs 10/44 (22.7%), w 2 (1) ¼ 1.3, P ¼ 0.3).…”

Section: Discussionsupporting

confidence: 90%

“…For these reasons, we decided to count and analyse all TM (X1 microlith per testes) in this study. Therefore, the frequency of TM we report for healthy male participants is higher than in some previous studies, which report TM as X5 microliths per testes (CTM) (Peterson et al, 2001;Serter et al, 2006). However, if we limit the definition of TM to X5 microliths, the frequency of CTM is similar to other analyses of asymptomatic men at 6/101 (5.9%).…”

Section: Discussionsupporting

confidence: 46%

“…No study has compared TGCT cases to control subjects without suspected testicular pathology. Two studies that examined the prevalence of TM among non-symptomatic army recruits (median age at ultrasound of 18 -20 years) showed approximately 6% had TM (defined as X5 microliths) (Peterson et al, 2001;Serter et al, 2006).Although previous data suggest that TM is a risk factor for TGCT, the frequency of TM in relatives of TGCT patients has never been examined. Furthermore, the familiality of TM itself has not previously been investigated.…”

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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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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 46%

mentioning

confidence: 99%

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confidence: 99%

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

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“…A literature survey documents an estimated prevalence between 0.6-9.0 % [12][13][14][15]. Differences in study population, e. g., size and age distribution, and research focus may offer explanations regarding the variations in TML prevalence in published studies.…”

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Testicular Microlithiasis

Feingold

2013

FRCR 2B Viva: A Case-Based Approach

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Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults

Tan

Ang

Ching

et al. 2010

Cancer

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BACKGROUND:There is an increasing body of literature associating testicular microlithiasis (TM), a common finding on testicular ultrasound, with testicular germ cell tumor (TGCT) and intratubular germ cell neoplasia of unclassified type (ITGCNU). Determining these associations is pertinent both clinically and biologically. To the authors' knowledge, no previous systematic review or meta-analysis has been performed. METHODS: A comprehensive systematic literature review was performed without language restrictions through July 2009 and included an exhaustive search of electronic databases and article references. Two reviewers extracted data independently. Studies were categorized according to the clinical context in which sonography was performed. The primary study outcomes were concurrent diagnoses of TGCT or ITGCNU, with TM. In addition, studies with prospective follow-up of patients with TM were reviewed. RESULTS: Thirty-three studies met inclusion criteria. TM was not associated with an increased risk of TGCT in asymptomatic men. However, in referral populations, TM was associated overall with a risk ratio of 8.5 (95% confidence interval [CI], 4.5-16.1; P < .001) for a concurrent diagnosis of TGCT and 10.5 (95% CI, 5.3-20.8; P < .0001) for ITGCNU. Seventeen observational studies were identified in which the interval development of TGCT in patients with TM was reported; however, the majority of those studies did not report the follow-up of a control arm and could not be summarized. CONCLUSIONS: In the presence of risk factors, TM was associated with a substantially elevated risk of a concurrent diagnosis of TGCT and ITGCNU. The authors suggest modifications to recently proposed guidelines for the management of TM. Cancer 2010;116:4520-32.

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The Prevalence of Testicular Microlithiasis in an Asymptomatic Population of Men 18 to 35 Years Old

Cited by 192 publications

References 30 publications

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

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

Testicular Microlithiasis

Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults

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