Snowstorm testes

Excerpt

The “snow storm testis” describes the appearance of multiple 1–3 mm diameter echogenic, non-shadowing foci within the parenchyma of the testicle that resembles snowflakes falling during a blizzard (Fig. 1), when testicular microlithiasis (TM) is imaged at ultrasound (Fig. 2) [1]. The first description of TM dates from 1970 [2]. The diagnosis of classic TM by imaging is now defined by the presence of at least five echogenic foci per ultrasound field [3]. The pathophysiology and clinical significance of TM is debated, and its presence has been associated with a number of conditions, including male infertility, Klinefelter syndrome, cryptorchidism, and alveolar microlithiasis [3, 4]. An increased risk of testicular neoplasms in the presence of TM, especially germ-cell variants, has also been suggested (Fig. 3) [1, 3‐5]. This last association has produced some controversy with regard to the use of imaging for surveillance and follow-up; however, the most recent recommendations do not support routine surveillance in low-risk patients with TM.

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