testicular microlithiasis

Testicular microlithiasis is a well-defined clinical and pathologic entity easily diagnosed through testicular echography.

Its association with cancer and infertility is now under debate. Many efforts have been done in recent years to clarify the spectrum of lesions observed in testicular microlithiasis.

The presence of microliths in the testis is a frequent finding throughout all ages. In children, they have been mainly described in undescended testis, Klinefelter’s syndrome, male pseudohermaphroditism, and in normal infants.

In adults, microliths have been observed in cryptorchidism and in undescended testis treated with orchiopexy, in seminiferous tubules adjacent to germ cell tumors, in some infertile men, and in some patients consulting for orchialgia or asymmetric testicular size.

The term testicular microlithiasis (TM) has been traditionally used in those cases containing a great number of microliths. Systematic sonographic testicular explorations have defined two types of TM: classic TM, when the number of microliths is more than 5, and limited TM, when the number is less than 5.

Although many studies have been published in recent years on the association between TM and both infertility and testicular cancer, no reports have been found of microlithiasis of the epididymis and the rete testis.

Etiology

 McCune-Albright syndrome (GNAS1 mutations mosaicism) (15520771)

• unilateral macroorchism in McCune-Albright syndrome (GNAS1 mutations mosaicism)

Differential diagnosis of microliths

 corpora amilacea
 Michaelis-Gutmann bodies
 calcium deposits
 hyaline globules
 parasites

• Dioctophyme renale

See also

 epididymal microlithiasis
 rete testis microlithiasis

References

 Nistal M, Garcia-Cabezas MA, Regadera J, Castillo MC. Microlithiasis of the epididymis and the rete testis. Am J Surg Pathol. 2004 Apr;28(4):514-22. PMID: 15087671