Testicular microlithiasis: US follow-up

PURPOSE: To determine in patients with testicular microlithiasis (TM) the s hortterm natural history of classic TM (CTM) and limited TM (LTM). MATERIALS AND METHODS: In 104 patients, testicular microliths were identifi ed on ultrasonographic (US) images; 39 patients had five or more microliths on at least one US image (criterion for CTM), and 65 patients had fewer th an five microliths (criterion for LTM). Attempts were made to have all pati ents return for follow-up US to assess for change in TM or development of t umor. RESULTS: Seven (18%) of the 39 patients with CTM and one (2%) of the 65 pat ients with LTM had tumor at presentation (P = .004). Among all 104 patients , follow-up US was performed in 72 patients (31 with CTM, 41 with LTM), wit h mean follow-up of 45 months (range, 12-90 months). None of these patients had interval development of testicular neoplasm. LTM did not progress to C TM in any patient. Progression in number of microliths was seen in two pati ents with CTM. CONCLUSION: Patients with LTM have a lower prevalence of associated maligna ncy than do patients with CTM. The risk of developing malignancy in patient s with isolated TM (LTM or CTM) is low at short-term follow-up. These resul ts raise the question of the need for routine US in this patient population .