Management of Testicular Microlithiasis in Children: A Single-Center Experience

INTRODUCTION: Testicular microlithiasis (TM) is a rare condition characterized by asymptomatic calcification of seminiferous tubules. There is limited data on the natural history and risk of developing testicular malignancy in patients with pediatric TM. The aim of study was to review our experience in children with TM and to compare and evaluate the management of TM in light of literature.
METHODS: The retrospective study included pediatric patients (aged below 18 years) that were diagnosed with TM by scrotal ultrasonography (US) in our center between May 2015 and May 2020. Demographic characteristics, physical and US examination findings, and follow-up records were reviewed for each patient.
RESULTS: A total of 12 children diagnosed with TM were analyzed. The mean age at presentation was 6.6±3.5 years and the mean follow-up period (time between the first and last US examinations) was 31.2±16.2 (range, 8–56) months. The most common US indication was scrotal pain (n=4), followed by trauma (n=3), unilateral undescended testis (n=3), bilateral undescended testis (n=1), and Down syndrome with bilateral orchiopexy (n=1). Calcific density showed no significant change in US throughout the follow-up period. Serum α-fetoprotein and β-human chorionic gonadotropin levels were within normal limits in all patients and no testicular germ cell tumors or new abnormal symptoms were detected in any patient throughout the follow-up period.
DISCUSSION AND CONCLUSION: No testicular cancer or new abnormal findings were detected in patients with TM throughout the follow-up period. Further studies with larger patient series and longer follow-up periods are needed to develop a standard management algorithm.