Testicular microlithiasis, a rare and little-known disease: Case reports and a literature review

Authors

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v81i1.727

Keywords:

Testicular microlithiasis, Ultrasound, Children

Abstract

Objective: The aim of the present work was to review the cases of testicular microlithiasis revealed by ultrasound and carry out a review of the literature.

Design: Testicular ultrasounds that identified testicular microlithiasis in patients seen at the Hospital “Dr. Manuel Gea González”, within the time frame of 2011 and 2018, were reviewed. Age, study indication, and laterality were among the variables analyzed.

Results: Twenty-one ultrasounds revealed testicular microlithiasis in patients ranging from 6 to 24 years of age, with a mean of 16 years. Both testes were affected in 81% of the patients, and the left testis was affected in 29%. The indication for ultrasound was testicular pain in 33% (7 cases), testicular tumor in 14% (3 cases), and testicular torsion in 10% (2 cases). Other causes were varicocele, testicular abscess, and testicular trauma.

Study limitations: The conclusions were relative, given the study’s retrospective, observational design. 

Originality: Microlithiasis has a reported prevalence of 2.4% to 3.8% in children. It is associated with testicular tumors and can cause infertility. A possible cause is nanobacteria that induce testicular calcifications. The study of the disease could modify its treatment and prevent its appearance. 

Conclusions: Testicular microlithiasis is a rare and little-known disease that can be associated with cancer and infertility. Its etiology appears to be nanobacterial infection. More research on the disease should be carried out.

References

Riccabona M, Lobo ML, Augdal TA, Avni F, Blickman J, Bruno C, et al. European Society of Paediatric Radiology Abdominal Imaging Task Force recommendations in paediatric uroradiology, part X: how to perform paediatric gastrointestinal ultrasonography, use gadolinium as a contrast agent in children, follow up paediatric testicular microlithiasis, and an update on paediatric contrast-enhanced ultrasound. Pediatr Radiol. 2018 Sep;48(10):1528–36. doi: 10.1007/s00247-018-4147-3

Lin X-C, Gao X, Lu G-S, Song B, Zhang Q-H. Role of calcifying nanoparticles in the development of testicular microlithiasis in vivo. BMC Urol. 2017;17(1):99. doi: 10.1186/s12894-017-0289-0

Maturen KE. Attributable risk calculations for testicular microlithiasis. J Clin Ultrasound. 2015;43(2):120–1. doi: 10.1002/jcu.22257

Xu C, Liu M, Zhang F, Liu J, Jiang X, Teng J, et al. The Association Between Testicular Microlithiasis and Semen Parameters in Chinese Adult Men With Fertility Intention: Experience of 226 Cases. Urology. 2014;84(4):815–20. doi: 10.1016/j.urology.2014.03.021

Richenberg J, Brejt N. Testicular microlithiasis: is there a need for surveillance in the absence of other risk factors? Eur Radiol. 2012;22(11):2540–6. doi: 10.1007/s00330-012-2520-4

Nakamura M, Moriya K, Nishimura Y, Nishida M, Kudo Y, Kanno Y, et al. Prevalence and risk factors of testicular microlithiasis in patients with hypospadias: a retrospective study. BMC Pediatr. 2018;18. doi: 10.1186/s12887-018-1151-6

Zhang Q-H, Lu G-S, Shen X-C, Zhou Z-S, Fang Q, Zhang X, et al. Nanobacteria may be linked to testicular microlithiasis in infertility. J Androl. 2010;31(2):121–5. doi: 10.2164/jandrol.109.007930

Sakamoto H, Saito K, Shichizyo T, Ishikawa K, Igarashi A, Yoshida H. Color Doppler ultrasonography as a routine clinical examination in male infertility. International Journal of Urology. 2006;13(8):1073–8. doi: https://doi.org/10.1111/j.1442-2042.2006.01499.x

Qublan HS, Al‐Okoor K, Al‐Ghoweri AS, Abu‐Qamar A. Sonographic spectrum of scrotal abnormalities in infertile men. Journal of Clinical Ultrasound. 2007;35(8):437–41. doi: https://doi.org/10.1002/jcu.20326

Martel J, Peng H-H, Young D, Wu C-Y, Young JD. Of nanobacteria, nanoparticles, biofilms and their role in health and disease: facts, fancy and future. Nanomedicine (Lond). 2014;9(4):483–99. doi: 10.2217/nnm.13.221

Kajander EO, Ciftçioglu N. Nanobacteria: an alternative mechanism for pathogenic intra- and extracellular calcification and stone formation. Proc Natl Acad Sci U S A. 1998;95(14):8274–9. doi: 10.1073/pnas.95.14.8274

Hunter LW, Charlesworth JE, Yu S, Lieske JC, Miller VM. Calcifying nanoparticles promote mineralization in vascular smooth muscle cells: implications for atherosclerosis. Int J Nanomedicine. 2014;9:2689–98. doi: 10.2147/IJN.S63189

Kutikhin AG, Brusina EB, Yuzhalin AE. The role of calcifying nanoparticles in biology and medicine. Int J Nanomedicine. 2012;7:339–50. doi: 10.2147/IJN.S28069

Miller VM, Rodgers G, Charlesworth JA, Kirkland B, Severson SR, Rasmussen TE, et al. Evidence of nanobacterial-like structures in calcified human arteries and cardiac valves. AM J PHYSIOL. 2004;287(3 56-3):H1115–24. doi: 10.1152/ajpheart.00075.2004

Cisar JO, Xu DQ, Thompson J, Swaim W, Hu L, Kopecko DJ. An alternative interpretation of nanobacteria-induced biomineralization. Proc Natl Acad Sci U S A. 2000;97(21):11511–5. doi: 10.1073/pnas.97.21.11511

Drancourt M, Jacomo V, Lépidi H, Lechevallier E, Grisoni V, Coulange C, et al. Attempted Isolation of Nanobacterium sp. Microorganisms from Upper Urinary Tract Stones. J Clin Microbiol. 2003;41(1):368–72. doi: 10.1128/JCM.41.1.368-372.2003

Benzerara K, Miller V, Barell G, Kumar V, Miot J, Brown G, et al. Search for Microbial Signatures within Human and Microbial Calcifications Using Soft X-Ray Spectromicroscopy. Journal of investigative medicine : the official publication of the American Federation for Clinical Research. 2006;54:367–79. doi: 10.2310/6650.2006.06016

Ciftçioglu N, Björklund M, Kuorikoski K, Bergström K, Kajander EO. Nanobacteria: an infectious cause for kidney stone formation. Kidney Int. 1999;56(5):1893–8. doi: 10.1046/j.1523-1755.1999.00755.x

Ciftçioglu N, McKay DS, Kajander EO. Association between nanobacteria and periodontal disease. Circulation. 2003;108(8):e58-59; author reply e58-59. doi: 10.1161/01.CIR.0000086781.16968.2D

Altundag K, Altundag O, Akyurek S, Atik MA. Possible association between nanobacteria and malignant microcalcifications in breast cancer. Breast J. 2006;12(3):287. doi: 10.1111/j.1075-122X.2006.00264.x

Published

2021-03-05

Issue

Section

Original articles