Coexistence of Condylomata Acuminata with Warty Squamous Cell Carcinoma and Squamous Cell Carcinoma

Abstract

Introduction: Condyloma acuminatum has previously been considered to be a benign growth with no malignant potential, but a review of the literature supports the concept that condylomata acuminata may precede or be associated with invasive squamous cell carcinoma (ISCC) or warty squamous cell carcinoma (WSCC).

Case report: We present a clinical case of a 58-year old woman with large, slow-growing, exophytic tumor of external genitalia shaped like a cauliflower with the propagation to both legs and behind. We performed multiple biopsies to detect potential malignancy but malignancy was not confirmed histologically. The presence of HPV (human papilloma virus) low and high risk was discovered. Inguinal lymph nodes were enlarged both sides, but cytologic examination identified no malignant cells. The patient was initially treated by the loop electro surgical excision procedure (LEEP) and podophilin solution on the rest of the condylomas. Condyloma acuminatum was confirmed histologically. Later, we performed a wide surgical excision of the rest of the condylomas. The new changes on the previously treated region were removed using LEEP. WSCC and ISCC were confirmed histologically so were radical vulvectomy and inguinal lymphadenectomy performed. The patient was advised to remain under close follow-up.

Keywords: HPV; condyloma acuminatum; vulvar cancer.

Figure 1

58-year old woman with large, slow-growing, exophytic tumor of external genitalia shaped like a cauliflower with propagation to both legs and behind.

Figure 2

PHD 10814/2010 Condylomata acuminata 100 x JPEG

Figure 3

The patient was initially treated by the loop electrosurgical excision procedure (LEEP) and podophilin solution on the rest of the condylomas.

Figure 4

PHD 11405/2010 Ca condylomatosum et condylomata acuminata 50 x JPEG

Figure 5

The appearance of vulvar region after the end of therapy.