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Eur J Pediatr Surg 2017; 27(02): 155-160
DOI: 10.1055/s-0036-1572552
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Follow-Up of Testicular Microlithiasis in Children and Adolescents: Multicenter Prospective Cohort Study of the Italian Society of Pediatric Urology

Antonio Marte
1   Division of Pediatric Surgery, Second University of Naples, Naples, Italy
,
Lucia Pintozzi
1   Division of Pediatric Surgery, Second University of Naples, Naples, Italy
,
Giuseppe Cretì
2   Division of Pediatric Urology, “Casa Sollievo della Sofferenza” Hospital, IRCCS-San Giovanni Rotondo, Italy
,
Pierluigi Lelli Chiesa
3   Division Pediatric Surgery, “Santo Spirito” Hospital-G. D'Annunzio University-Chieti-Pescara, Pescara, Italy
,
Dacia Di Renzo
3   Division Pediatric Surgery, “Santo Spirito” Hospital-G. D'Annunzio University-Chieti-Pescara, Pescara, Italy
,
Marco Gasparella
4   Division of Pediatric Surgery, Hospital of Treviso-Padua University, Treviso, Italy
,
Giovanni Di Maggio
5   Department of Medical Sciences, Surgery and Neuroscience, Siena University, Siena, Italy
,
Vincenzo Bagnara
6   Unit of Pediatric Surgery, “G.B. Morgagni” Hospital, Catania, Italy
,
Emilio Merlini
7   Division of Pediatric Urology, S. Anna Hospital, Torino, Italy
,
Barbara Tadini
7   Division of Pediatric Urology, S. Anna Hospital, Torino, Italy
,
Eustachio Caldarulo
8   Division of Pediatric Surgery OO.RR., Hospital of Foggia, Foggia, Italy
,
Luciano Sangiorgio
9   Unit Pediatric Urology, “SS. Antonio e Biagio e Cesare Arrigo” Hospital, Alessandria, Italy
,
Gianfranco Battaglino
10   Division of Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy
,
Simona Gerocarni Nappo
11   Division of Pediatric Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Paolo Caione
11   Division of Pediatric Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
› Author Affiliations
Further Information

Publication History

23 October 2015

15 January 2016

Publication Date:
10 March 2016 (online)

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Abstract

Introduction Testicular microlithiasis (TM), characterized by the presence of intratubular calcifications in a single or both the gonads, is an uncommon entity with unknown etiology and outcome in pediatric and adolescent age. In this study, the results of a multicenter long-term survey are presented.

Materials and Methods From 11 units of pediatric urology/surgery, patients with TM were identified and yearly, followed up in a 7-year period, adopting a specific database. The recorded items were: age at diagnosis, presenting symptoms/associated abnormalities, ultrasonographic finding, surgery and histology at biopsy, if performed.

Results Out of 85 patients, 81 were evaluated yearly (4 patients lost to follow-up). TM was bilateral in 66.6% of the patients. Associate genital abnormalities were present in 90%, more frequently undescended/retractile testis (23.4%) and varicocele (22.2%). TM remained unchanged at 4.7 years follow-up in 77 patients (93.8%) and was reduced in 4 patients after 1 to 5 years of inguinoscrotal surgery. Orchiectomy was performed in three patients (3.7%), one for severe testicular hypoplasia and two for seminoma (2.5%), respectively, concurrent and metachronous to diagnosis of TM. Tumorectomy with parenchymal sparing surgery was performed in a teratoma associated with TM.

Conclusion TM is a controversial entity, often associated with several inguinogenital features, which rarely can recover. Testicular malignancy, although present in TM, has not proven definitively associated to microliths. Proper counseling, yearly ultrasound, and self-examination are long-term recommended.

Keywords

testicular microlithiasis - microcalcifications - gonadal dysgenesis - seminoma - germ
 

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