Search

Cancers of the rete testis are uncommon and usually occur in the 6th or 7th decade of life. The prognosis is dreadful. Approx. 40% of the affected patients die within 1 year after diagnosis due to progression of the disease. The primary therapy is surgical. Until now there is no effective chemotherapy. In our case following primary inguinal orchiectomy and confirmation of the diagnosis, a radical retroperitoneal lymphadenectomy and wide local resection were performed. One positive lymph node was found and adjuvant radiotherapy was performed. In this case preoperative PET/CT was not helpful. For the last 3 years now the patient has been disease free. Since cancers of the rete testis are very rare and the literature is scarce, we would like to recommend the introduction of a national registry.

Objective: To determine the role of cervical cytology and colposcopy in the management of endocervical neoplasia. Setting: Colposcopy unit and cytology laboratory in a teaching hospital. Sample: Group 1 included 184 smears showing endocervical glandular neoplasia from 129 patients and group 2 included 101 patients with histology showing endocervical abnormalities in a 6-year period (1993–1998). Follow-up of 6–11 years to 2004 was available. Methods: Group 1 were identified from the cytology computer records. Group 2 were identified from histology records on the cytology database and a record of histology cases kept for audit purposes. The clinical records were examined retrospectively. Results: The positive predictive value (PPV) of abnormal endocervical cells in smears was 81.1% for significant glandular/squamous [cervical glandular intraepithelial neoplasia (CGIN)/cervical intraepithelial neoplasia grade2 (CIN2 or worse)] lesions. The PPV of colposcopy was 93.5% for significant glandular/squamous lesions of the cervix. The postcolposcopy probability of a significant lesion when colposcopy was normal was 87.5%. The sensitivity of colposcopy in detecting endocervical lesions was 9.8%. The sensitivity of cervical smears in detecting a significant endocervical abnormality (CGIN or worse) was 66.3%. The false negative rate for cytology of endocervical glandular lesions was 4.0%. Conclusions: Endocervical glandular neoplasia detected on cytology is predictive of significant cervical pathology even when colposcopy is normal, which supports excisional biopsy in the primary assessment of these smears. The high concomitant squamous abnormality rate justifies the use of colposcopy to direct biopsies from the ectocervix. Cervical cytology is the only current screening method for cervical glandular abnormalities but sensitivity is poor. [ABSTRACT FROM AUTHOR]

How predictive is a cervical smear suggesting glandular neoplasia The prevalence of endocervical adenocarcinoma and its precursors has increased, in part due to increased diagnostic awareness of these lesions. To date, limited information has been published regarding the predictive value of glandular abnormalities in cervical smears. This study details the histological follow up of 418 cervical smears showing glandular abnormality, reported in our department over a six year period from 1993 to 1998. Histological follow up was available for 395 of the 418 smears (94.50%). The overall positive predictive value (PPV) for this group of smears was 72.66% for either significant glandular or squamous pathology (at least low grade cervical glandular intraepithelial neoplasia or CIN2 on follow up biopsy), and 55.70% for significant glandular pathology alone. Examination of subcategories of abnormal glandular smear showed that the PPV increased with the degree of abnormality reported within the smears. [ABSTRACT FROM AUTHOR]