Ultrasound Findings: Bright Spots on Testes in Children

Ultrasound examination revealed multiple echogenic foci in the testis?

Dear Dr.
Huang,
Thank you for taking the time to respond amidst your busy schedule.
I would like to inquire about my first-grade child, who was found to possibly have a hernia during a school health check.
An ultrasound examination at a teaching hospital unexpectedly revealed multiple bright spots in the testicles.
After a six-month follow-up, the findings remain unchanged.
Could you please explain why this might be the case? What are the possible causes? How should we proceed with treatment?
The physician who performed the ultrasound was in a hurry to attend class and advised me to research online for more information.
During our first visit to the pediatric surgeon, he did not comment much on the ultrasound report, only stating that no hernia was detected.
When we reminded him about the numerous bright spots found during the ultrasound, he still felt it unnecessary to explain our concerns regarding the report, suggesting that the likelihood of any issues was very low and only recommended follow-up examinations.
However, as parents, we have many doubts and worries.
Could you please recommend a physician in the Taichung area who has more experience and time to conduct further examinations and treatment for us? We are also open to traveling to Taipei if necessary.
Thank you once again for your kind assistance.

Sincerely,
A concerned mother

Wang Mama, 40~49 year old female. Ask Date: 2010/04/19

Dr. Huang Yuanhui reply Surgery

The presence of bright spots on ultrasound indicates that the tissue has a stronger acoustic reflection.
In the case of a 7-year-old boy's testicular tissue, a common reason for this is underdeveloped testicular tissue, which is denser compared to other tissues and reflects more sound waves, potentially resulting in bright spots.
Another possibility is the presence of calcification due to a previous inflammation.
If the size and shape of the testicles are normal, regular follow-up examinations are recommended.
In the central region, you may consider seeking services from pediatric or pediatric surgical specialists at medical centers such as Taichung Veterans General Hospital, China Medical University Hospital, Chung Shan Medical University Hospital, or Changhua Christian Hospital.

Reply Date: 2010/04/19

More Info

When it comes to ultrasound findings in children, particularly the presence of bright spots on the testes, it is essential to approach the situation with a clear understanding of what these findings may indicate and the potential implications for the child's health and development.

Bright spots on ultrasound, also referred to as echogenic foci, can arise from various causes. In pediatric patients, these findings are often benign and may not signify any underlying pathology. Common reasons for bright spots in the testes include:
1. Calcifications: These can be small deposits of calcium that are often harmless and may resolve over time. They can occur due to various reasons, including previous infections or trauma.

2. Epididymal cysts: These are fluid-filled sacs that can develop in the epididymis, the tube that carries sperm from the testes. They are generally benign and do not require treatment unless they cause discomfort.

3. Testicular microlithiasis: This condition involves the presence of tiny calcifications within the testes. While it is often benign, it has been associated with an increased risk of testicular cancer, so monitoring is essential.

4. Infection or inflammation: Conditions such as epididymitis or orchitis can lead to changes in the ultrasound appearance of the testes, including bright spots.

5. Other benign lesions: There are various other benign conditions that can present as bright spots on ultrasound, and many of these do not require intervention.

Given that the ultrasound findings have remained stable over six months, this is generally reassuring. Stability in imaging findings often suggests that the lesions are not aggressive or indicative of a serious condition. However, it is crucial to maintain regular follow-up with a pediatric urologist or a pediatric surgeon who specializes in such conditions.

In terms of treatment, if the bright spots are determined to be benign and not causing any symptoms or complications, the typical approach is to continue monitoring. If any changes occur, or if the child begins to experience symptoms such as pain or swelling, further evaluation may be warranted.

For your concerns about finding a qualified physician in Taichung or Taipei, I recommend seeking out a pediatric urologist or a pediatric surgeon with experience in managing testicular conditions. You can start by consulting with your child's pediatrician, who can provide referrals to specialists in your area. Additionally, academic medical centers often have pediatric specialists who are well-versed in these types of conditions.

In summary, while the presence of bright spots on ultrasound can be concerning for parents, many of these findings are benign and require only monitoring. It is essential to maintain open communication with healthcare providers and ensure regular follow-up to address any concerns that may arise. If you have further questions or if new symptoms develop, do not hesitate to seek additional medical advice.

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