Testicular microlithiasis


  • Presence of more than five foci of calcification per ultrasound field view randomly distributed in the testicular parenchyma

  • May be due to deregulated phagocytic activity of Sertoli cells (undestroyed apoptotic testicular germinal epithelium in the seminiferous tubules, undergoing calcification)

  • Composed of pure calcium hydroxyapatite

  • Both genetic and environmental factors suspected in pathogenesis

Clinical features


  • 1.5%–5.6% overall prevalence in North America and Europe; up to 14% in the African American community

  • Increased prevalence in deprived socioeconomic groups

  • Can be seen in both children and adults

  • 66%–80% bilateral

  • Reported:

    • in cryptorchid and ex-cryptorchid (9.5%) testes

    • in subfertile patients (0.8%–20%)

    • in men with Klinefelter syndrome (17.5%) and in men with Down syndrome (36%)

    • 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

    • in association with in-situ or invasive germ cell tumors (>30%) in descended and undescended testes

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