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. 2020 Aug 6;18(5):1248-1252.
doi: 10.5114/aoms.2020.97997. eCollection 2022.

Warty carcinoma of the uterine cervix: a virus-induced disease?

Angel Danchev Yordanov  1 , Ivan Ivanov  2 , Tereza Dineva  3 , Stanislav Slavchev  4 , Stoyan Kostov  4 , Strahil Strashilov  5 , Assia Konsoulova  6
Affiliations

Warty carcinoma of the uterine cervix: a virus-induced disease?

Angel Danchev Yordanov et al. Arch Med Sci. .

Abstract

Introduction: Warty carcinoma (WC) of the uterine cervix is a rare subtype of squamous-cell carcinoma (SCC), and its frequency, clinical behaviour, and aetiology are obscure. It originates from condylomas, and a viral carcinogenesis seems logical.

Material and methods: Retrospective analysis was performed of all cervical carcinomas (CC), diagnosed at a single institution for a 10-year period. Analysed patients had stage I carcinoma. Patients with WC were identified, and their tumour samples were tested for high-risk HPV (hr-HPV) and EBV, using PCR and ISH. Clinical characteristics and WC rates across all stage I CC patients were assessed. All patients had minimum 3-year follow-up, and overall survival (OS) and 5-year survival rates were calculated.

Results: WC comprised 2.2% of all stage I CC (n = 630). The mean age of the patients was 48 years (range: 29-72). The primary tumour size was 2 cm in 4 (28.6%) patients, 2-4 cm in 2 (14.3%) patients, and 4 cm in 8 (57.1%) patients. Lymph node metastasis was found in 1 (7.1%) patient. EBV or hr-HPV were detected in 2 (18.2%) patients using ISH, with no coinfection reported. Hr-HPV was detected in 2 (18.2%) patients; EBV in 4 (36.4%) cases, and in 2 of them (18.2%) there was a co-infection. Thirteen patients had a follow-up of ≥ 5 years and their 5-year OS was 100%.

Conclusions: WC is a rare subtype of SCC with good prognosis, regardless of viral status. In contrast to SCC, its aetiology is not related to hr-HPV. The role of EBV remains unclear and cannot currently be denied.

Keywords: Epstein-Barr virus; aetiology; human papillomavirus; in situ hybridisation; polymerase chain reaction; warty carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Signals produced by HPV probe in nuclei in warty carcinoma cases. ISH 400×
Figure 2
Figure 2
Signals produced by EBV probe in nuclei in warty carcinoma case. ISH 400×
See this image and copyright information in PMC

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