What can be recommended for testicular microlithiasis diagnosis in childhood

Czech version

Authors: Ivo Novák; Miloš Bro Ák
Authors‘ workplace: Urologická klinika, Fakultní nemocnice a Lékařská fakulta UK, Hradec Králové
Published in: Ces Urol 2021; 25(1): 40-47
Category: Original Articles

Overview

Novák I, Broďák M. What can be recommended the testicular microlithiasis diagnosis in childhood.

Introduction: Testicular microlithiasis (TM) is a rare disease in the pediatric population. A possible link with testicular tumors (TC) requires appropriate attention to the disease. The paper describes in multiple case reports our personal experiences with this disease.

Materials and Methods: TM were found in 5 patients during screening ultrasound (USG) examination of the testes performed due to other pathologies of the scrotum (hydrocele, testicular retention, varicocele) or positivity in the family history of TC in the years 2010–2020. The age of the patients at the time of diagnosis was 18–155 months (average = 98, median = 126 months). All of them had characteristic bilateral finding. At the same time there were diverse risk factors present in three patients (history of seminoma in the fathers of two patients, one patient after bilateral orchidopexy).

Results: All 5 patients are routinely observed for 12–72 months (average = 50, median = 72 months), perform autopalpation of the testes once a month and undergo USG once a year. In 4 patients there were no changes in the sense of palpation or USG finding that would raise a suspicion of TC. In one patient a small cyst was described on the right testis during one of the control USG at another urology department. During USG at our department a contralateral multiple cystic formation of the epididymis – spermatocele – was found, however a cyst was not found in the right testicle. The usual standard procedure with autopalpation and USG controls followed.

Conclusion: We observed three risk cases of TM with risk factors. Therefore all the patients are monitored not only by autopalpation monthly but also by USG annually. No patient has been indicated for biopsy or orchiectomy yet. For all of them, we expect transfer to subsequent transient care in adulthood.

Keywords:

Testicular microlithiasis – testicular tumors – childhood – ultrasonography

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