Testicular calcifications

common causes of testicular calcification

1. Testicular Calcifications
Hisham AlKhatib, M.D.
Consultant Radiologist

2. • هلا ىلعو الله لوسر ىلع ملاسلاو ةلاصلاو لله دمحلا
نيعمجا مّلسو هبحصو
• ، املع يندزو ينعفني امب ينملعو ينتملع امب ينعفنا مهللا
ميكحلا ميلعلا كنا
• Praise be to Allah and prayers be upon the
Messenger of Allah and his family and
companions.
•Oh God, give me the benefit of what you
have taught me and teach me what benefits
me.

3. ESSENTIAL INFORMATION

4. •Correlation between clinical and sonographic
features essential
–Incidental finding: Testicular microlithiasis, scrotal
pearl
–History of pain: Abscess, chronic infections,
tumors
–Mass with intrinsic calcification: Testicular tumors,
epidermoid cyst
–Associated with trauma: Testicular hematoma,
hematocele

5. DIFFERENTIAL DIAGNOSIS

6. •Common
•Less common
•Rare but important

7. Common Causes

8. •• Testicular Microlithiasis
•• Nonseminomatous Germ Cell Tumor
•• Sertoli Cell Tumor

9. Helpful Clues for Common
Diagnoses

10. Testicular Microlithiasis
•Multiple small (2-3 mm), discrete,
nonshadowing, echogenic intratesticular foci
•Unilateral or bilateral involvement
•Concurrent germ cell tumor in up to 40%

15. Nonseminomatous Germ Cell
Tumor
•Complex solid-cystic testicular mass
•Heterogeneous echogenic foci due to
calcification ±fibrosis, along with
retroperitoneal lymphadenopathy can be seen
with burnt out testicular tumor
•Calcifications more common in tumors that
contain teratomatous components

17. Sertoli Cell Tumor
•Small, hypoechoic, solid-cystic mass
•Punctate calcification may be present
•Occasionally, tumoral calcification may form
large calcified mass, known as large calcifying
Sertoli cell tumor

21. Less Common Causes

22. •• Scrotal Trauma
•• Scrotal Pearl
•• Epidermoid Cyst
•• Scrotal Abscess or Epididymoorchitis
•• Calcified Tunica Albuginea Cyst

23. Helpful Clues for Less Common
Diagnoses

24. Scrotal Trauma
•Chronic hematocele
–Complex echogenic fluid
–If chronic, appears as heterogeneous echogenic
mass, ±calcification
–No intrinsic vascularity on Doppler

26. Scrotal Pearl
•Calcification of detached testicular epididymal
appendages due to previous inflammation or
torsion of appendages
•Solitary, discrete, echogenic focus in tunica
vaginalis

29. Epidermoid Cyst
•Lamellated appearance on ultrasound
•May have peripheral calcified rim

32. Scrotal Abscess or Epididymoorchitis
•Tuberculous infections may produce
intrascrotal calcifications, scrotal sinuses
•Granulomas appear as small echogenic foci, ±
calcification

34. Calcified Tunica Albuginea Cyst
•Typically located at anterosuperior aspect of
testis
•Within tunica albuginea; may cause mass
effect on testicular parenchyma if large
•Avascular

36. THANK YOU