Testicular Microlithiasis: Case Report and Literature Review

Abstract

Testicular microlithiasis is a condition characterized by the ultrasonographic findings with multiple microliths, with the prevalence of 0.6% to 9%. This is a condition of unknown etiology; however, in many cases it may be associated with cryptorchidism, Klinefelter syndrome, Down syndrome, varicocele, testicular torsion and male pseudohermaphroditism. Many retrospective studies point to the association between testicular microlithiasis and testicular cancer. We report a case of a 50-year-old patient who presented to the urologist because of dysuric symptoms. Ultrasonographic examination of both testicles revealed microcalcifications in large numbers, i.e. "the phenomenon of the starry sky". More than 20 microcalcifications were present on the cross section of both testicles. Standard laboratory blood tests were normal. Prostate-specific antigen was 1.22 ng/ml. If risk factors for developing cancer are present, some authors recommend a biopsy of the testicles. However, based on the literature review, currently, there is no a strictly defined protocol.