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Purpose: The object of our study was to examine the clinical significance of pediatric testicular microlithiasis (TM) as it relates to testicular cancer. Materials and Methods: Seven boys in whom TM was incidentally detected were followed for a mean of 51±44 months (range: 9-119 months) for testicular cancer surveillance. The average patient age at the initial diagnosis was 9.8±2.5 years. The frequency of coincidental TM detected on scrotal ultrasonography performed for all clinical purposes at our institution between January 1997 and January 2008 was investigated. Eighty-two testicular cancer patients and 1,006 noncancer patients underwent ultrasonography between 1997 and 2006, and these patients were divided into two age groups (children, age <15 years; adults, age ≥15 years) for purposes of analysis. Results: Of the seven patients followed solely for TM, none developed testicular cancer during the surveillance period. Coincidental TM seen on scrotal ultrasonography was significantly higher in the testicular cancer patients than in the noncancer controls (11% (9/82) vs. 3.5% (36/1,006), p <0.0001). According to the age groups, TM was found in 6% and 5.8% of the testicular cancer patients and the noncancer controls, respectively, in the children’s group, whereas in the adult group, 11.6% and 3.3% of the patients in the respective groups were found to have TM. Conclusions: The incidence of testicular cancer development in children with incidentally detected TM was very low, and the incidence of coincidental TM in children with testicular cancer did not differ from that in the noncancer control patients. However, the significantly higher incidence of TM accompanying testicular cancer after puberty may suggest an association of the two pathologies, which would then mandate cancer surveillance in cases of incidentally detected TM in this age group. (Korean J Urol 2009;50:57-60)

The Clinical Significance of Pediatric Testicular Microlithiasis in Relation to Testicular Tumors