Squamous-cell carcinoma of the anus arising in a giant condyloma acuminatum

Sturm, James T.; Christenson, Carl E.; Uecker, John H.; Perry, John F.

doi:10.1007/bf02587163

Cited by 49 publications

(10 citation statements)

References 5 publications

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“…[30][31][32] Why this lesion would be associated with a low-risk HPV type is unclear, but an alteration involving control genes for early transcription of HPV 6 has been reported in some cases. 30,33 Those cases that progress to invasive squamous cell carcinoma may harbor an additional highrisk HPV type.…”

Section: Verrucous Carcinoma (Giant Condyloma Of Buschke and Lowenstein)mentioning

confidence: 99%

Diagnostic Problems in Anal Pathology

Longacre¹,

Kong²,

Welton

2008

Advances in Anatomic Pathology

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Anal squamous cell carcinoma and its precursor lesions are increasing in incidence in the United States and Europe. This trend predates human immunodeficiency virus/acquired immune deficiency syndrome and has been associated with persistent high-risk human papilloma virus (HPV) genotype infection, previous lower genital tract dysplasia/carcinoma, high frequency anoreceptive intercourse, heavy cigarette smoking, immunosuppression in solid organ transplant and immune disorders, and human immunodeficiency virus seropositivity. Screening protocols for at-risk patients are under active investigation and pathologists are often asked to assess anal canal and perianal biopsies for the presence of dysplasia and/or invasive carcinoma. Because underdiagnosis and overdiagnosis of anal cancer and precancer may lead to inappropriate treatment, it is important for the pathologist to be aware of current screening strategies, specific risk lesions, and the role of pathology in initial diagnosis and evaluation of anal biopsy and/or resection specimens. Standardized histologic criteria and uniform terminology should be used for reporting all anal canal and perianal squamous intraepithelial lesions. HPV subtyping, anal cytology, and recently identified biomarkers, such as p16 and Becton Dickinson ProEx C may provide additional information in problematic cases, but it is important to be aware of the limitations of these assays. HPV has been linked to all the major histologic subtypes of anal carcinoma (eg, basaloid, cloacogenic, transitional, etc.) and this association is strongest for anal canal lesions. With the possible exception of the microcystic pattern, histologic subtype does not seem to predict prognosis; and anal squamous cell carcinomas should be classified as either keratinizing or nonkeratinizing. Poorly differentiated squamous cell carcinomas have a worse prognosis and should be distinguished from poorly differentiated adenocarcinoma, melanoma, and neuroendocrine tumors. Very well differentiated squamous cell carcinoma with pushing margins (so-called giant condyloma of Buschke and Lowenstein) should be classified as verrucous carcinoma; this tumor shows aggressive local infiltration but does not metastasize. As all anal condylomata may harbor foci of high-grade dysplasia or invasive carcinoma, careful sectioning and complete histologic examination is required.

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Section: Verrucous Carcinoma (Giant Condyloma Of Buschke and Lowenstein)mentioning

confidence: 99%

Diagnostic Problems in Anal Pathology

Longacre¹,

Kong²,

Welton

2008

Advances in Anatomic Pathology

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“…fat, muscle, bone, etc.) by expansion, formation of fistulous tracts and recurrent abscesses [5,7], Despite the rarity of malignant transformation in condyloma acu-minatum, BLT has a 37% risk of transformation into squamous cell carcinoma in situ [6,20,21]. Fortunately, our case was not complicated either by recurrence or malignant transformation in the 18-month follow-up peri od.…”

Section: Discussionmentioning

confidence: 69%

“…However, treatment with these methods (i.e., chemotherapy, electrodesiccation, radio therapy, immunotherapy) have all had limited success in BLT [5,6,10,[20][21][22][23][24][25][26] (table 3). In pregnancy the pres ence of maternal BLT carries the risk of neonatal con tamination and requires a cesarean section [25], Sponta neous regression was reported in a pregnant patient after birth.…”

Section: Discussionmentioning

confidence: 99%

Buschke-Löwenstein Tumor of the Anal Region

Ulualp¹,

Aydemir²,

Eyüboğlu³

et al. 1993

Dig Surg

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Giant invasive condyloma acuminatum, also known as Buschke-Löwenstein tumor, is a human papilloma virus (HPV) type 6 or 10-associated lesion which is rarely seen in the anorectum. These lesions despite their histologic benignity are clinically malignant with a propensity for recurrence and invasion. The aggressive character of this lesion and its likelihood of malignant transformation together with the associated significant mortality require early surgical excision with clear margins. Authors report on a patient with giant perianal condyloma acuminatum who was treated in a single session by total excision and fasciocutaneous VY advancement flap.

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“…The consistency of the data over the longer time period it highlights the importance of treating anal/perianal warts to remove IN that may eventually progress to invasive cancer as has previously been reported in the literature. (Scholefield, Castle and Watson 2005, Siegel 1962, Sturm et al 1975 In particular the rates of anal cancer are rapidly rising in men with HIV (Crum-Cianflone et al 2010) and it may be that men with warts represent a population of men at increased risk especially given the relatively common findings of anal cancer in men with warts (8.8%). Genital warts are recognised as a risk factor for the development of IN in renal transplant recipients.…”

Section: Discussionmentioning

confidence: 99%