  Case of the Week - Patient Summary 3210Peer Reviewed and Certified - | |
| Demographics: 34 y.o. man | |
| History & Chief complaint: | |
| 34 y/o male who presents to the ER with testicular pain. | |
| Physical exam and Laboratory: | |
| Left testicle was very hard and smaller than the right testicle. | |
| Summary of Findings: | |
| Microlithiasis bilaterally with heterogenous hypoechoic mass in the left testicle. | |
| Differential Diagnosis: | |
| Diagnosis: | |
 Testicular Microlithiasis | |
| Treatment and Followup: | |
| Left orchiectomy was performed with the pathology given as mixed germ cell tumor. | |
| Microlithiasis of the testicle is defined by five or more microliths per cross-sectional image. The condition may be bilateral. Sonography demonstrates many small, usually non-shadowing, possibly comet-tailing, diffusely scatterred hyperechoic foci within the testicular parenchyma. The microliths are thought to arise from calcification of corpora-amylacea-like bodies in the seminiferous tubules. Microlithiasis has been identified in both normal and cryptorchid testis and in individuals diagnosed with Klinefelter's syndrome, male pseudohermaphroditism and testicular neoplasms. (1)
Originally thought to be a benign process, some reports have shown an association between microlithiasis and occurence of a coexisting primary testicular neoplasm--up to 40% in one small series. (2) Current recommendations are to perform interval 6-month sonograms and appropriate tumor marker studies. (1) | |
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