Educational Support Meeting

[dadmo]

Bart:
Mikey had no chance to ask that. The meeting was moderated by a social worker who avoided answering any medical questions.

[Karen]

Two most recent reports...the first is cullind data from one center over 10 years and the second a literature review.

J Ultrasound Med. 2007 Jul;26(7):867-73.
Testicular microlithiasis: our experience of 10 years.Lam DL, Gerscovich EO, Kuo MC, McGahan JP.
University of California, Davis Medical Center, Sacramento, CA, USA.

OBJECTIVE: Testicular microlithiasis (TM) is characterized on sonography by multiple microprecipitates in the testes. The correlation between TM and testicular malignancies is variable. The purpose of this study was to review our 10-year experience regarding the prevalence of TM and its association with testicular malignancies. METHODS: This was a retrospective study in which 3254 testicular sonographic examinations over a 10-year period identified 137 patients with TM. Testicular microlithiasis was divided into 2 groups: classic TM (CTM; >or= 5 calcifications per image) and limited TM (<5 calcifications/image). A control population without TM was also randomly selected during the same period. Associations with testicular cancers and other findings were then noted and compared between the TM and control groups. RESULTS: One hundred thirty-seven (4.6%) of the 2957 individual patients with scrotal sonographic examinations had TM; 8 (5.8%) of the 137 patients with TM had testicular cancer, whereas 1 (0.73%) of the 137 patients without TM had primary testicular cancer (P = .04). There were 9 testicular neoplasms in 8 patients, all of whom had CTM. Thirty patients with TM and no malignancy were followed for an average of 19 months (range, 1-90 months; SD, 19.7 months); none had tumor development. CONCLUSIONS: We found a strong association between TM and testicular malignancy. We think that the most prudent use of resources for early detection of malignancy would be to have all patients with CTM perform testicular self-examinations, and follow-up sonography should be limited to a subgroup of patients with CTM and other associated risk factors.

Nat Clin Pract Urol. 2007 Sep;4(9):492-7.
Current management strategies for testicular microlithiasis.Jaganathan K, Ahmed S, Henderson A, Rané A.
James Paget Hospital, Great Yarmouth, UK.

The association of testicular microlithiasis with testicular tumor and the management of incidentally detected testicular microlithiasis have generated a great deal of interest. We review the current literature on testicular microlithiasis with regard to its association with testicular tumor. This association seems complex. The available data suggest that men with incidental findings of testicular microlithiasis but who have otherwise normal testes are at low risk of developing testicular cancer. The only follow-up recommended is regular testicular self-examination. Testicular microlithiasis is, however, associated with a high risk of developing testicular malignancy in men with subfertility, history of contralateral testicular tumor or history of cryptorchidism. Regular testicular self-examination is recommended for follow-up of high-risk patients, but the role of surveillance with serial ultrasonography and measurement of tumor markers is still not clear.

[Bart]

Thanks Karen. I think the association being complex with many variables would be a fair assesment. So is it common to label 8% as strong association in these types of analysis? Seems like quite a stretch.

Anyway, dadmo, didn't mean to hijack the thread. What do you think of such a meeting over the phone? I'm sure we could find a corporation to donate time on their call bridge.

Bart

[dadmo]

Danny:
I can't belive it's almost a year since we met. I don't ever go many days without thinking about you. I know you would have never chosen the path your life took but in many ways you are with us now just as you were before. I'm looking foward to riding with you and Scott in PA. I plan on wearing your picture for part of the ride, Scott's for another section and of course I need to wear my sons picture for the final push.
Continue to LOVEstrong
Billy