What’s testicular microlithiasis?

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Testicular microlithiasis is a rare condition characterized by clusters of microscopic deposits of calcium in the testicles. Scrotal ultrasound images can reveal the condition, which is diagnosed in about 0.5-0.6% of men who undergo such examinations. The causes of this condition are unknown but could include injury or infection and the condition is associated with Klinefelter syndrome, cryptorchidism, infertility, Down syndrome and alveolar microlithiasis. It is most often diagnosed in men who have complained of scrotal swelling or pain or who are being tested for infertility. There is no known treatment.

The calcifications found in this condition are usually distributed symmetrically in both testicles, but in 20% of cases the grouping is asymmetrical. Cases occurring in only one testicle have also been reported. A case involving five or more calcium clusters is termed classical testicular microlithiasis, and a case with fewer than five clusters is termed limited testicular microlithiasis.

This condition is associated with testicular cancer, with research using testicular ultrasound indicating that men who have this type of microlithiasis are three to four times more likely to develop cancer. Some research, such as that looking at scrotal ultrasound findings, has suggested that the likelihood of cancer is much higher, perhaps more than 20 times more likely. Consequently, medical professionals should screen patients who have the condition for testicular tumors, and annual ultrasound screenings and frequent patient self-examination are also recommended.

First identified in 1970, testicular microlithiasis has been observed in males as young as 10 months old. There is some indication that men who develop this condition earlier have a higher risk of developing testicular cancer than those who develop the condition later in life. The average age of men who have both testicular tumors and microlithiasis is about 30 years old.

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