Testicular microlithiasis: A review and its association with testicular cancer

Rashid, Hani; Cos, Louis R.; Weinberg, Eric; Messing, Edward M.

doi:10.1016/s1078-1439(03)00177-7

Cited by 67 publications

(47 citation statements)

References 35 publications

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“…After examining subgroups (symptomatic or asymptomatic) of patients in studies of various designs (case series, crosssectional, prospective, retrospective), several authors have reported the association of TM with testicular cancer [1,7,8] . Accordingly, it was found that the most common tumors were seminomas, teratomas and mixed germ cell tumors, in decreasing order [9] .…”

Section: Introductionmentioning

confidence: 99%

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

Şanlı

Kadıoğlu²,

Atar

et al. 2008

Urol Int

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Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the prevalence of associated testicular tumors. Methods: Patients diagnosed with CTM using scrotal ultrasound over a 5-year period from a referral radiology clinic were included in this study. Patients with CTM were categorized as group 1 (grade I; 5–10 microliths/image), group 2 (grade II 10–20 microliths/image), and group 3 (grade III > 20 microliths/image). Other pathological findings were also recorded. The prevalence of testicular cancer was compared statistically between groups using the χ² test. Results: Seventy-eight of 4,310 (1.8%) patients were found to have CTM. Of these, 17 (21.7%) had ultrasonographically detected testicular cancer. In patients without CTM (n = 4,232), 58 (1.1%) testicular cancers were found. This accounted to a 19.7-fold increase in the detection rate of testicular cancer in patients with CTM compared to patients without CTM. The rates of testicular cancer detected in groups 2 and 3 were 25 (6/24) and 26.6% (4/15), respectively (p > 0.05), while it was 17.9% (7/39) in group 1. Conclusions: CTM is an uncommon incidental finding in patients undergoing testicular ultrasonography, and grading of CTM plays no role in the prevalence of testicular cancer.

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Section: Introductionmentioning

confidence: 99%

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

Şanlı

Kadıoğlu²,

Atar

et al. 2008

Urol Int

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“…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 high frequency of TM associated with TGCT (range 12 -74%) compared to 0.68 -9% for other diagnoses (Rashid et al, 2004). No study has compared TGCT cases to control subjects without suspected testicular pathology.…”

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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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“…With the emerging evidence it seems safe not to routinely follow-up patients who are incidentally diagnosed with testicular microilithiasis [9][10][11]. They should however be advised to continue testicular self-examination.…”

Section: Discussionmentioning

confidence: 99%

“…However the importance of testicular microlithiasis in patients with a high risk of developing testicular tumour such as cryptorchidism, small atrophic testis, sub-fertile men and testicular tumour in the contra lateral testis is not clear and needs further evaluation [12,13]. With conflicting evidence for the rationale of routinely following patients with incidentally diagnosed testicular microlithiasis [9][10][11] we conducted a national survey to provide a snapshot of current attitudes towards investigation and surveillance of this patient group in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

Surveillance of Testicular Microlithiasis?: Results of an Uk-Based National Questionnaire Survey

Ravichandran¹,

Smith²,

Conford³

et al. 2006

European Urology Supplements

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Testicular microlithiasis: A review and its association with testicular cancer

Cited by 67 publications

References 35 publications

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

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

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

Surveillance of Testicular Microlithiasis?: Results of an Uk-Based National Questionnaire Survey

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