Premature conclusions on HPV-only testing - Authors' reply.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD, USA.
The Lancet Oncology (Impact Factor: 24.73). 10/2011; 12(11):993. DOI: 10.1016/S1470-2045(11)70240-6
Source: PubMed
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    ABSTRACT: Bilateral sex cord stromal testicular tumors are common in the syndrome of myxoma, spotty pigmentation and endocrine overactivity (Carney's complex). Large cell calcifying Sertoli cell tumor is the particular testicular tumor found in Carney's complex. A clinicopathological review of 26 patients is presented. We report 2 cases of Carney's complex with testicular tumors. An additional 24 patients with Carney's complex and testicular tumors were identified by MEDLINE search and review of the literature. Bilateral testicular tumors were found in 16 patients (61%) with a familial occurrence in 10 (38%). A testicular mass was the most common presentation. The associated findings of Carney's complex included cardiac myxoma in 16 patients, skin myxoma in 16, skin pigmentation in 15, Cushing's syndrome in 8, acromegaly in 3 and schwannoma in 3. Excisional biopsy, surveillance, bilateral orchiectomy and unilateral orchiectomy were performed in 7, 4, 7 and 8 patients, respectively. No local tumor recurrence or metastasis has developed in patients with bilateral and/or multifocal testicular tumors. Excisional biopsy or surveillance only are treatment options for bilateral testicular tumors in Carney's complex.
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    ABSTRACT: We review prepubertal germ cell tumors of testis in our institute and the Japanese registry and present 2 cases with a large cell calcifying Sertoli cell tumor (LCCSCT) and discuss the possibility of testis-sparing surgery. Incidence, age, pathology and clinical stages of prepubertal germ cell tumors are surveyed for 30 years at our department and 10 years of the malignant tumor registry of the Japanese Society of Pediatric Surgery. Two representative prepubertal boys with LCCSCT are presented. One of them was treated by partial orchiectomy. The majority of testicular germ cell tumors in the prepubertal age were composed of embryonal cell carcinoma/yolk sac tumors or teratoma, occurred in preschool age, were limited to clinical stage I and did not metastasize irrespective of histology. Benign behavior which included recovery from hormonal derangement, no tumor recurrence and negative antisperm antigen was observed in 2 cases with LCCSCT who underwent either radical orchiectomy or partial orchiectomy. Partial orchiectomy should be considered as a standard option in prepubertal schoolboys with a testicular mass if surgically feasible. This surgical treatment is safe and preserves fertility and is psychologically advantageous. It is not recommended for yolk sac tumors that may recur, however they are rare in prepubertal boys and can be differentiated preoperatively by prudent evaluation.
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    ABSTRACT: Our 10-year experience with non-testicular intrascrotal tumors has been combined with an extensive survey of the literature. The over-all incidence of malignancy affecting intrascrotal structures is high: 1) 25 per cent of epididymal neoplasms are malignant, 2) excluding cord lipomas, 56 per cent of cord tumors are malignant and 3) 59 per cent of scrotal tunic neoplasms are of malignant origin. Because of the high incidence of malignancy and because tumors of these structures are often misdiagnosed, a clinical approach to the diagnosis and management of non-testicular intrascrotal masses is presented.
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