Testicular Microlithiasis in Pediatric Patients

Objective: Testicular microlithiasis (TM) is characterized by parenchymal calcifications, identified as hyperechoic, shadowless foci measuring between 1 and 3 mm in diameter within the testicular parenchyma. This condition is typically detected incidentally through ultrasonography in rare inguinal-scrotal disorders in pediatric patients. TM has been linked to various pathological conditions of the testis, notably an elevated risk of tumor development. A retrospective review of TM cases was conducted to assess clinical features and long-term follow-up outcomes.

Materials and Methods: This retrospective analysis was conducted over a 12-year period involving children diagnosed with TM through scrotal Doppler ultrasonography at our outpatient clinic. Medical records were examined to evaluate patient age, indications for ultrasound, associations with inguinal-scrotal pathologies, and follow-up findings.

Results: In this study, fifty-six patients aged between 2 and 17 years (median age of 9 years) were included. Bilateral TM was observed in all cases, except for 15 patients who exhibited unilateral foci. Among the participants, 27 patients (48.2%) presented with concomitant inguinal-scrotal pathology, while 3 patients (5.3%) had systemic disease. Notably, microlithiasis and Leydig cell tumors were identified in one patient who underwent ultrasonography due to testicular pain.

Conclusion: TM is predominantly bilateral and of the classic type, with testicular pain potentially indicating its presence. Ultrasonography is generally adequate for both the diagnosis and monitoring of testicular microlithiasis. An association with testicular tumors is noted, particularly within the pediatric population. Given that both benign and malignant lesions are linked to TM, studies involving larger populations and extended follow-up periods are warranted.

Keywords : Child, Leydig cell tumor, testicular microlithiasis, ultrasonogrphy