An Insight into Testicular Macrocalcification: A Retrospective Study of 42 Cases on a Rare Sonographic Finding

A single testicular microlithiasis is a common finding during sonography, while macrocalcification is a rare and incidental finding. The literature on macrocalcification is limited. Typically, testicular calcifications, whether microscopic or macroscopic, are benign but they can have a clinical significance. This multicenter study aimed to investigate the symptoms and prevalence of testicular cancer in patients with macrocalcification. Methods: Testicular ultrasound examination reports from four hospitals’ PACS database, covering the period 2014–2023, were screened for diagnoses of macrocalcification. Inclusion criteria required that the radiology report described macrocalcification supported by ultrasound images. Results: Macrocalcifications were identified in 42 male patients, with a mean age of 45 years. Sixteen macrocalcifications were in the right testicle, twenty in the left, and six were bilateral. Microlithiasis were found in 22 patients (52.4%), with 11 (26.2%) bilateral, 3 (7.1%) left-sided, and 8 (19.1%) right-sided. Testicular tumors were found in six patients. Conclusion: Testicular macrocalcification exhibited large visual variation and diverse clinical history. However, we found a low number of patients with testicular macrocalcification and testicular tumors, indicating that macrocalcifications have a benign nature, and that macrocalcification alone should not be a primary concern for malignancy, but this needs to be confirmed in further studies.