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Testicular microlithiasis
Definition
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Presence of more than five foci of calcification per ultrasound field view randomly distributed in the testicular parenchyma
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May be due to deregulated phagocytic activity of Sertoli cells (undestroyed apoptotic testicular germinal epithelium in the seminiferous tubules, undergoing calcification)
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Composed of pure calcium hydroxyapatite
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Both genetic and environmental factors suspected in pathogenesis
Clinical features
Epidemiology
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1.5%–5.6% overall prevalence in North America and Europe; up to 14% in the African American community
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Increased prevalence in deprived socioeconomic groups
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Can be seen in both children and adults
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66%–80% bilateral
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Reported:
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in cryptorchid and ex-cryptorchid (9.5%) testes
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in subfertile patients (0.8%–20%)
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in men with Klinefelter syndrome (17.5%) and in men with Down syndrome (36%)
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in association with other benign conditions such as varicocele, scrotal trauma, mumps, epididymal cyst, testicular torsion, pulmonary alveolar microlithiasis, calcifications in parasympathetic nervous system, and neurofibromatosis
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in association with in-situ or invasive germ cell tumors (>30%) in descended and undescended testes
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