Variation in the appearance of giant condyloma in an Ugandan series of cases of carcinoma of the penis

Abstract

Whole mount sections were made from all amputation specimen of patients treated for carcinoma of the penis in Mulago Hospital, Kampala, Uganda, during a 21-month period in 1968-1970. Among a total of 55 cases four tumors were found which were large, but histologically showed low invasiveness suggestive of absence of metastatic spread. There were two giant condylomas, and two giant condylomas showing possible microinvasion. Two further cases showed a small squamous cell carcinoma together with a giant condyloma in the remainder of tumor. The most chracteristic feature was an orderly, well-circumscribed, expansive downgrowth, leaving little stroma to be seen between the epithelial masses to tumor. Within these limits, however, the spectrum of growth pattern, differentiation, and malignant change was very wide and much more varied than in tumors recorded form Western countries. This should be remembered when a presumptive diagnosis of the condition is to be made on small routine biopsies. Additional changes showing marked similarities to condylomata acuminata were often seen in superficial portions of tumor. This transition in histological picture within one tumor favors the view that giant condyloma is an intermediate lesion in the development of cancer in condylomata acuminata.

Verrucous Carcinoma of Skin

“…Verrucous carcinoma has been classified as a non-metastasizing, locally destructive, but not invasive type of neoplasm (Brownstein & Shapiro 1976, Headington 1978, Kraus & Perez-Mesa 1966, Ackerman 1948. Several examples in the literature (Dawson et al 1965, Friedberg & Serlin 1963, Oranje et al 1976, Demian et al 1973, Kovi et al 1974, Rhatigan & Saffos 1977, Schmauz et al 1977, Siegel 1962, Sturm et al 1975) and three of our five cases (Table 1) show that it is in fact a squamous cell carcinoma with a potential to produce invasive growth. However, the invasion is usually microscopic, foeal and superficial.…”

Human Papillomavirus Type 6 Associated Buschke‐Loewenstein Tumor (Giant Condyloma Acuminatum)

“…Many koilocytes are observed, but the obvious hallmarks of true malignancy are not commonly found. It is a giant form of viral wart (5,6), although it has rather high probability of becoming a premalignant or a truly malignant squamous tumor (15)(16)(17). Human papillomavirus type 6 (HPV-6) and type 11 (HPV-11) have been detected from tumor tissues (2-6), although HPV-16 was detected exceptionally (18).…”

Condylomatous tumours of vulva, vagina, and penis. Relation between histological appearance and age.

“…According to the enclosed clinical description, five of the 17 cases were sores or swellings, three were papillary tumours, and in six the characteristic appearance of giant condyloma was noted, namely, a large, fungating growth destroying the organ; in two cases no details had been given. One case, seen in its dimensions on the histological section, showed clearly that there are also small tumours displaying features typical of giant condyloma.7 9 Wellcircumscribed downgrowth of the rete ridges could be seen, but no true invasion. In the example shown in Fig.…”

“…Furthermore, the term verrucous carcinoma was Received for publication 10 March 1980 introduced, embracing all these kinds of tumours,6 or referring only to giant condylomata acuminata showing malignant change in the form of true invasion.7 However, another proposition is to retain the term verrucous carcinoma only for cases that show invasion by large epithelial islands conforming to a solid growth pattern8 and to describe in full detail whatever combinations are seen within a single tumour. 9 When analysing their age distribution in biopsy series of cases, two groups ofcondyloma acuminatum were found which occurred mainly in young and less often in elderly persons and thus preceded the cases of carcinoma by decades and years, respectively, suggesting perhaps that these lesions are precancerous. They showed a low risk and long time interval to subsequent carcinoma in young patients and a high risk and short time interval in older patients.10-'2 It seemed likely that there were variations not only in age distribution but also in histological appearance, and it was decided, therefore, to reassess the cases from Uganda where most material had been collected.…”