Comorbidity between HTLV-1-associated adult T-cell lymphoma/leukemia and verrucous carcinoma: a case report

Abstract

Background: Adult T-cell Leukemia/Lymphoma (ATLL) is classified as a peripheral CD4+ T-cell neoplasm caused by the human T-cell lymphotropic virus type 1 (HTLV-1). Typical symptoms are associated with leukemic infiltration; however, atypical and exaggerated manifestations of verrucous carcinoma have also been described. Case report: We present here the case of a patient with multiple skin lesions, ischemic necrosis in the hallux and lymphadenopathies. Biopsies were taken, which showed verrucous epidermal carcinoma and cutaneous lymphoma. Splenomegaly and adenopathy in mesentery, retro peritoneum and lymph node chains in the limbs were observed. Bone marrow examination showed findings compatible with T-cell leukemia/lymphoma; and it was ELISA positive for HTLV-1/2. Treatment and outcome: The patient had a good initial response to a CHOP scheme (cyclophosphamide, doxorubicin, vincristine and prednisone) with filgrastim. However, the patient had a relapse and died before the second cycle. Clinical relevance: Comorbidity could lead to the associated risk factors model. According to this model, secondary immunodeficiency caused by HTLV-1 may induce the development of verrucous carcinomas; alternatively, the disease could be due to a correlation between HTLV-1 and the human papillomavirus (HPV).

Lymphotropic Viruses EBV, KSHV and HTLV in Latin America: Epidemiology and Associated Malignancies. A Literature-Based Study by the RIAL-CYTED

“…There are multiple reports of ATLL in South America, mostly describing a disease with similar features to Japan ATLL, but in younger individuals. In Colombia, 19 HTLV positive ATLL cases have been reported, 12 confirmed as HTLV-1, while, in the others, the HTLV subtype was not investigated [246][247][248][249]. On the other hand, about 200 of TSP/HAM cases have been documented, with half of them confirmed to be in HTLV infected individuals [249,[447][448][449][450][451].…”

Microbial Biofilms: Human T-cell Leukemia Virus Type 1 First in Line for Viral Biofilm but Far Behind Bacterial Biofilms

“…ATL is characterized by pathologic amplification of transformed infected cells without the need of persistent viral production. One of the important clinical manifestations of ATL is the infiltration of leukemic cells from the blood into various organs, such as lymph nodes, spleen, lungs, and skin (Kaneko et al, 2015;Valencia and Moreno, 2017;Farès et al, 2018;Sharma et al, 2018). Strikingly, HTLV-1 viral production is not constant in ATL, but sporadic due to thin regulating mechanisms allowing evasion from host immune surveillance (Miyazato et al, 2016).…”

Whole-Transcriptome Sequencing–Based Profiling of the Cutaneous Virome in Patients with Secondary Immunodeficiency

“…Many families have a well-defined immune deficiency due to compromised T-cell immunity or the keratinocyte-intrinsic immune system ( Biglari et al, 2024 ). In addition to genetically determined susceptibility to viral infections in patients with primary immune deficiency, many cases have been documented where the cutaneous lesions are associated with acquired immune deficiency, for example, secondary to acquired immune deficiency syndrome or human T-lymphotropic virus 1 (HTLV1) infections ( Akinboro et al, 2013 ; Cockerell, 1991 ; Valencia and Moreno, 2017 ).…”