Testicular Microlithiasis: Prospective Analysis of Prevalence and Associated Tumor

Middleton, William D.; Teefey, Sharlene A.; Santillan, Cynthia

doi:10.1148/radiol.2242011137

Cited by 105 publications

(85 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many studies in the literature limit reports of TM to five or more microcalcifications (CTM). However, this cutoff is arbitrary and studies, which include LTM (one to four microcalcifications) also demonstrate an association with TGCT (Bennett et al, 2001;Middleton et al, 2002). For these reasons, we decided to count and analyse all TM (X1 microlith per testes) in this study.…”

Section: Discussionmentioning

confidence: 99%

“…For each examinable testis, TM was counted, categorised and recorded as shown in Table 1, based on the model described by Backus et al, (1994). We performed analyses based on any TM (X1 microlith in a testes) also described as Limited TM (LTM) and on TM X5 microliths per testes, referred to as Classical TM (CTM) (Middleton et al, 2002).…”

Section: Methodsmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2007

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Middleton et al . (2002) distinguished between classic and limited THF, the classic form representing pronounced THF as described here, while limited THF rather seems to be identical to bTHF.…”

Section: Discussionmentioning

confidence: 54%

Prevalence of small testicular hyperechogenic foci in subgroups of 382 non‐vasectomized, azoospermic men: a retrospective cohort study

Fedder

2017

Andrology

View full text Add to dashboard Cite

SummaryTesticular hyperechogenic foci (THF) are associated with Klinefelter's syndrome, cryptorchidism, infertility, and testicular germ cell neoplasia. The aims of the study were to evaluate THF in relation to etiology of azoospermia and to Sertoli cell dysfunction. The structures inside the scrotum of consecutive non‐vasectomized, azoospermic were examined by ultrasonography, and hormone (FSH, LH, testosterone, and prolactin), and genetic analyses (karyotype, Y microdeletions, and CFTR mutations) were performed. At testicular ultrasonography, patients were graduated into: pronounced THF (>7 THF per transducer field), distributed universally (uTHF) or collected in plaques (pTHF), borderline THF (bTHF; 3–7 THF per transducer field), or no THF (<3 THF per transducer field). Diagnostic testicular biopsy was taken open or with TruCut needle (14G). THF status was sufficiently described in 382 of 449 potential participants, and testicular histology was available in 300 cases. Presence of ultrasonographically detectable THF was compared to presence of testicular microlithiasis (TM) detected histologically. Sertoli cell dysfunction was investigated in a subgroup using a three‐stage immunoperoxidase technique for detection of cytokeratin‐18 (CK‐18). The prevalence of THF was 13.4%. uTHF was found in 11 men (2.9%), the pattern was bilateral in four while other four had bTHF in the other testis. pTHF was detected in eight cases (2.1%), and except for one case with Klinefelter's syndrome, pTHF was in all cases occurring unilaterally. bTHF was detected in 32 cases (8.4%), bilaterally in 17 (53%). Pronounced THF was significantly associated with testicular malignancy. CK‐18 was detected in more azoospermic men with sperm production in ≤50% seminiferous tubules than in azoospermic men with spermatogenesis in ≥90% of seminiferous tubules and normal controls (p < 0.05). Unfortunately, TM detected histologically was not detected in any patient expressing THF, and neither THF nor TM was detected in any of the patients examined for CK‐18. Sertoli cell dysfunction was not associated with testicular microlithiasis or hyperechogenic foci.

show abstract

“…TML prevalence varies considerably in studies of asymptomatic men (0.6–9.0%) (Derogee et al ., 2001; Miller & Sidhu, 2002; Kim et al ., 2003; Goede et al ., 2009) compared to symptomatic (e.g. pain, lump or swelling) men (8.7–18.1%) (Bach et al ., 2001; Middleton et al ., 2002; Deganello et al ., 2012). In populations with genetic disorders, the prevalence of TML has been reported as high as 17.5% in men with Klinefelter syndrome (Accardo et al ., 2015) and 36.0% in men with Down's syndrome (Cebeci et al ., 2015).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of symptomatic men with testicular microlithiasis – A Danish cross‐sectional questionnaire study

et al. 2017

View full text Add to dashboard Cite

SummaryTesticular microlithiasis (TML) is an incidental finding at ultrasonography of the scrotum. A link between testicular microlithiasis and testicular cancer has been suggested. However, the majority of studies are retrospective using ultrasonography with minor data on health status and life style characteristics. Our objective was to investigate if lifestyle and health are associated with TML. In 2014, we conducted a self‐administered questionnaire survey including 1538 men, who all due to testicular/scrotal symptoms had an ultrasound investigation of the scrotum during 2004–2013. The men were divided into men with TML and men without. The 23‐items questionnaire included items on age, height, weight, lifestyle (alcohol consumptions, smoking habits, workload, exercise and food), previous diseases in the testicles, pain and consumption of analgesics. The prevalence of TML was 12.8%. Overall, lifestyle factors did not vary between men with or without TML. However, men with TML did consume more crisp than men without. Development of TML was not associated to classic life style factors such as alcohol consumption, smoking habits, or mothers smoking during pregnancy. Also, age and height could not be linked to presence of TML. We did find, however, that men with TML experienced less physical activity and consumed more crisp than men without TML. Since ingestion of crisps has potential carcinogenic effect (acrylamide), this finding needs confirmation in a separate study.

show abstract

Testicular Microlithiasis: Prospective Analysis of Prevalence and Associated Tumor

Abstract: Approximately one of 27 patients had CTM, and one of seven had LTM. Although a majority of patients with testicular tumors had coexistent TM, more than 90% with TM (both CTM and LTM) did not have tumor at presentation.

Cited by 105 publications

References 19 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

Prevalence of small testicular hyperechogenic foci in subgroups of 382 non‐vasectomized, azoospermic men: a retrospective cohort study

Characteristics of symptomatic men with testicular microlithiasis – A Danish cross‐sectional questionnaire study

Contact Info

Product

Resources

About