Testicular microlithiasis preceding metastatic mixed germ cell tumor--first pediatric report and recommended management of testicular microlithiasis in the pediatric population.

Testicular microlithiasis is a condition that has been associated with testis cancer in men and boys. We report the case of a 16-year-old boy who developed metastatic mixed germ cell testicular tumor in the setting of testicular microlithiasis detected by previous ultrasonography. The tumor developed in between semiannual visits and was detected by self-examination. Chest imaging revealed 2 lung lesions, and the beta-human chorionic gonadotropin level was elevated at presentation. Because of the particular nature of healthcare surveillance in the pediatric population, we recommend annual surveillance of boys with testicular microlithiasis, including physical examination, repeated instruction regarding self-examination, and ultrasonography.