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Testicular microlithiasis is an uncommon condition in which multiple calcifications develop in the seminiferous tubules. Sonography demonstrates a typical pattern of diffuse, hyperechoic specks. This condition has been associated with premalignant and malignant changes of the testicle. We present a case of intratubular germ cell neoplasia and a microscopic focus of seminoma found in a patient with isolated testicular microlithiasis and no focal mass. Physicians should be more aware of testicular microlithiasis, and heightened surveillance is recommended to identify progression to tumor formation.
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