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Condyloma Acuminatum of Urinary Bladder: Relation to Squamous Cell Carcinoma
- Source :
- American Journal of Surgical Pathology, 43(11), 1547-1553. LIPPINCOTT WILLIAMS & WILKINS
- Publication Year :
- 2019
-
Abstract
- Condyloma acuminatum rarely occurs in the urinary bladder and is considered to be a risk factor for squamous cell carcinoma, although there are only a few publications with limited cases. We studied 51 cases of condyloma acuminatum of the urinary bladder from transurethral resections of the urinary bladder of 38 patients from the consult files of one of the authors. Transurethral resections of the urinary bladder were obtained from 25 males with a median age of 73 years (range: 41 to 87 y) and 13 females with a median age of 68 years (range: 30 to 86 y). The follow-up period ranged from 15 months to 20 years (median: 6 y). Bladder lesions were accompanied by urethral lesions in 4 men. Eight patients (8/38; 21.0%) had a history of immunosuppression. Seven patients (7/8; 87.5%) from this group had multiple and/or recurrent condylomas. One patient (1/38; 2.6%) with renal transplantation had 10 separate bladder condylomas over time. One patient (1/38; 2.6%) had extensive anogenital condylomas and anal intraepithelial neoplasia grade 3. One patient (1/8; 12.5%) with renal transplantation presented with a solitary condyloma with synchronous squamous cell carcinoma in situ. Three female patients (3/38; 7.9%) had a history of premalignant vagina/cervix lesions. In total, 17 patients (17/38; 44.7%) had squamous cell carcinoma of the bladder, either invasive or in situ. In all cases, the squamous cell carcinoma (either in situ or invasive) was diagnosed either concurrent with the diagnosis of bladder condyloma or within 1 year of the condyloma diagnosis). In total, 9 of 38 (23.7%) patients had invasive squamous cell carcinoma with or without in situ squamous cell carcinoma. Eight of 38 (21.0%) patients had squamous cell carcinoma in situ only (without a definitive invasive component-in 3 cases invasive squamous cell carcinoma could not be excluded with certainty). In total, 19 patients (19/38; 50%) were positive for either low-risk human papillomavirus (LR-HPV) or high-risk human papillomavirus (HR-HPV) or both (3 were positive for both LR-HPV and HR-HPV, 12 patients for only LR-HPV, and 4 for only HR-HPV). Of the 19 patients that were negative for both LR-HPV and HR-HPV, 9 of 19 (47.4%) patients had associated squamous cell carcinoma. Of the 12 patients with only LR-HPV, 4 (33.3%) had associated squamous cell carcinoma (either invasive or in situ). Of the 7 patients with HR-HPV (with or without LR-HPV), 4 (57.1%) has associated squamous cell carcinoma. In summary, condyloma acuminatum of the urinary bladder shows a strong association with squamous cell carcinoma of the bladder, regardless of the condyloma's HPV in situ hybridization results. Immunosuppression is associated with condylomas of the bladder. It is important to distinguish bladder condylomas from papillary urothelial carcinoma, given their different risks for panurothelial disease and risk of squamous cell carcinoma. Recognition of bladder condylomas histologically is often challenging given their rarity, and that they can be negative for both LR-HPV and HR-HPV. The lack of a history of other anogenital human papillomavirus-related lesions further increases the difficulty in establishing the correct diagnosis.
- Subjects :
- 0301 basic medicine
squamous cell carcinoma
Adult
Male
medicine.medical_specialty
HPV
Urinary system
CLINICOPATHOLOGICAL ANALYSIS
Urology
urologic and male genital diseases
Pathology and Forensic Medicine
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Risk Factors
Carcinoma
Medicine
Humans
Basal cell
Aged
RISK
Aged, 80 and over
Urinary bladder
LESIONS
business.industry
Follow up studies
Urinary Bladder Diseases
Condyloma Acuminatum
Middle Aged
medicine.disease
030104 developmental biology
medicine.anatomical_structure
Urinary Bladder Neoplasms
Condylomata Acuminata
030220 oncology & carcinogenesis
Carcinoma, Squamous Cell
condyloma acuminatum
Surgery
Female
Anatomy
business
urinary bladder
Precancerous Conditions
Follow-Up Studies
Subjects
Details
- ISSN :
- 15320979 and 01475185
- Volume :
- 43
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The American journal of surgical pathology
- Accession number :
- edsair.doi.dedup.....ffacab297f0f21420fb69da19bcad1f5