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

UNLABELLED: 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.