Background: Verrucous carcinoma is a slowly growing, well-differentiated neoplasm with a predilection for the oral cavity. Objective: Data on the association of human papillomavirus (HPV) with oral verrucous carcinoma are very scarce. We searched for the presence of HPV in different stages of the tumour in a patient repeatedly treated by means of surgery, cryotherapy, radiotherapy and chemotherapy over a decade. Methods: HPV DNA was detected in archival tumour tissue by nested PCR. HPV types were identified based on restriction fragment analysis. Results: HPV type 11 was found in 1 early-stage and HPV 16 in 2 late-stage biopsy specimens of the tumour. Conclusion: Our findings provide further evidence for a role of HPV in oral verrucous carcinoma. The case history emphasizes the importance of a joint clinicopathological approach to this tumour.

A computer simulation approach is used to test assumptions about sensitivity of mammography and physical examination, and about the duration of preclinical screen-detectable breast cancer. Values between 50% and 80% for the combined sensitivity of the 2 tests give a good explanation of the results of the HIP randomized trial of breast cancer screening. The mean duration of the preclinical stage can vary from 1.6 years for high sensitivity values to 2.7 years for low values. In comparison with previous analyses of the HIP data our estimate for the sensitivity is lower, and the mean duration of the preclinical stage is longer. This is a consequence of the use of a more detailed model in our analysis, allowing for a more complete use of the HIP data in testing model assumptions. Similar analyses of data from recent screening projects in The Netherlands resulted in compatible estimates for the duration of preclinical breast cancer.

The diagnosis of male genitourinary tuberculosis is seldom apparent until the disease is far advanced. The earliest clinical symptoms in most cases are epididymitis, dysuria, and hematuria. In the present case, evaluation of a 26-year-old male complaining about primary infertility revealed leukocytospermia and a normal sperm count. The diagnosis of genitourinary tuberculosis was based on positive morning urine culture. Infertility is an uncommon first sign of male genitourinary tuberculosis, but may be a clue to early diagnosis, as demonstrated in the present case.

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