Cases reported "Carcinoma, Verrucous"

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1/10. Penile hybrid verrucous-squamous carcinoma associated with a superficial inguinal lymph node metastasis.

    A 62-year-old Japanese man who presented with penile carcinoma is reported. The initial exophytic neoplasm excised from the coronal sulcus and prepuce on the abdominal side of the penis was diagnosed histologically as verrucous carcinoma. Twenty-six months after the primary operation, an epithelial neoplasm recurred within the scar of the primary operation. The neoplasm histologically showed verrucous carcinoma and multiple invasive foci of conventional squamous cell carcinoma in the advancing edge of the tumor, as such representing a hybrid verrucous-squamous carcinoma. A lymph node metastasis in the left superficial inguinal lymph node occurred 4 months after the second operation. A total bilateral inguinal lymphadenectomy was performed and revealed no other lymph node metastases. The patient is alive without local recurrence or evidence of metastases in pelvic lymph nodes or visceral organs 2 years after the resection of the hybrid verrucous-squamous carcinoma. The initial verrucous carcinoma, recurrent hybrid verrucous-squamous carcinoma, and metastatic lymph node were negative for human papillomavirus DNA type 6, 11, 16, 18, and 33 sequences by dot blot hybridization of polymerase chain reaction products. The characteristics of hybrid verrucous-squamous carcinoma and importance of lymph node metastasis in penile carcinoma are discussed.
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2/10. Histological diagnosis of cutaneous "warty" carcinoma on a pre-existing HPV lesion.

    A middle-aged man with an 8-year history of a fungating tumour mass on his thigh was histologically diagnosed as having an invasive "warty" carcinoma at the location of a pre-existing human papillomavirus (HPV) lesion. The tumour surface had a verruciform appearance with papillae containing fibrovascular cores. Many of the malignant cells displayed changes consistent with koilocytotic atypia. We noticed a greater degree of nuclear atypia in comparison with a verrucous carcinoma. Focally, some neoplastic cells demonstrated features of basaloid differentiation. Under in situ hybridization conditions, only HPV16 DNA, which is commonly associated with genital neoplasia, was detected selectively in rather superficial areas, corresponding to morphological evidence of HPV infection (i.e. koilocytotic atypia). It is worth noting that cutaneous location of such a warty carcinoma is very rare.
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3/10. Verrucous carcinoma arising in hidradenitis suppurativa.

    There are many reported cases of squamous carcinoma complicating hidradenitis suppurativa, but only one previous mention of verrucous carcinoma in this setting. We describe a case of verrucous carcinoma arising in hidradenitis suppurativa of the anal margin in a non-immunosuppressed man. This is the second report of verrucous carcinoma arising in a lesion of hidradenitis suppurativa. Although hidradenitis suppurativa can involve multiple intertriginous sites, malignant degeneration occurs mostly in the anogenital region. This suggests a role for a regional factor which, when combined with chronic inflammation, predisposes to malignant degeneration. A likely candidate for this factor is human papillomavirus; our case showed histologic evidence for this, but the specimen did not show viral DNA by polymerase chain reaction in situ hybridization. The ability of anogenital hidradenitis suppurativa to form squamous and verrucous cancers reinforces the argument for early and complete resection.
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4/10. Warty carcinoma of the oral mucosa in an hiv patient.

    The authors present the case of a 36-year-old hiv male patient with a 1-cm diameter papillary exophytic lesion of the right cheek. Microscopic examination showed a papillary epithelial neoplasm with invasion of the stroma in the peripheral part. Cellular and nuclear atypia were present in the superficial and in the deep layers of the neoplasm. An in situ hybridization for human papillomavirus (HPV) 6, 11, 16, 18, 31, 35 and 51 was performed. A focal positivity only for HPV 16 and 18 was present in koilocytotic cells of the most peripheral portion of the lesion. The microscopic definitive diagnosis was warty carcinoma of the cheek. No recurrence was observed at a 3-year follow-up.
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5/10. Mixed tubulopapillary hidradenoma and syringocystadenoma papilliferum occurring as a verrucous tumor.

    Tubulopapillary hidradenoma (TPH)1 is a term proposed to describe morphological dermal ductal tumors with both eccrine and apocrine differentiation. The term TPH encompasses a spectrum of lesions that includes tubular apocrine adenoma (TAA) and papillary eccrine adenoma (PEA):2 PEA and TAA can be indistinguishable both clinically and histologically. We described a case of TPH with both prominent eccrine and apocrine differentiation combined with syringocystadenoma papilliferum (SCAP) over the distal extremity. This rarely encountered dermatopathological phenomenon is the sixth reported case from the literature in which PEA or TAA and SCAP were present in the same lesion.3-7 Furthermore, the tumor had a warty surface, which is histologically consistent with a typical viral verruca. Although PCR and DNA probe hybridization for human papilloma virus (HPV) types 2, 6/11, 16 and 18 failed to reveal positive results, the location and clinicopathologic correlation convinced us that superimposed HPV could not be excluded.
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6/10. carcinoma cuniculatum of the esophagus.

    AIMS: Extremely well-differentiated squamous cell carcinoma with the features of so-called carcinoma cuniculatum (CC) is a rare neoplasm. We describe the clinicopathologic findings of the first 2 cases of CC of the esophagus. methods AND RESULTS: Two elderly men presented with symptoms and clinical signs of esophageal malignancy. Repeated endoscopic biopsies of their esophageal tumors were inconclusive. Resection revealed CC of the esophagogastric junction in both cases. The tumors extended into the adventitia but no lymph node metastases were present. in situ hybridization for human papillomavirus HPV subtypes was negative. CONCLUSION: carcinoma cuniculatum is reported for the first time in the esophagus. The diagnosis of this tumor variant is difficult by means of cytological examination or by endoscopic biopsies alone. carcinoma cuniculatum in this location shows biologic features similar to verrucous carcinoma (deep penetration, no lymph nodes metastases, and location at one end of the esophagus). No evidence of human papillomavirus could be demonstrated.
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7/10. Buschke-Loewenstein tumour infiltrating pelvic organs.

    We report a 42-year-old hiv-negative patient with a 12-year history of exceptionally extensive genital warts and coexisting verrucous carcinoma of the anogenital region (Buschke-Loewenstein tumour). Masses of both tumour and viral papillomas infiltrated the external genitalia, perineum and buttocks, pelvic diaphragm and parts of the lesser pelvis, as well as the urethra, prostate and parts of the urinary bladder, necessitating repeated surgical intervention and plastic reconstruction. Adjuvant interferon-alpha therapy was given without any lasting effects. Human papillomavirus type 6 was detected by DNA in situ hybridization and Southern blot analysis.
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8/10. Penile verrucous carcinoma with anaplastic transformation following radiotherapy. A case report with human papillomavirus typing and flow cytometric DNA studies.

    We report a case of penile verrucous carcinoma with anaplastic transformation after radiotherapy. A 49-year-old man with penile verrucous carcinoma initially underwent excision and chemotherapy followed by radiotherapy when the carcinoma recurred locally. Twenty-four months after the completion of radiotherapy, the verrucous cancer transformed to an anaplastic spindle-cell carcinoma, which resulted in his death 10 months after diagnosis. autopsy confirmed a huge hemorrhagic recurrent lesion and lung metastases. in situ hybridization with biotinylated dna probes did not detect any type of human papillomavirus (HPV) (types 6/11, 16/18, and 31/33/51) in either the primary or the anaplastic tumor. Immunohistochemical HPV capsid antigens were also negative in both lesions. A flow cytometric analysis, using paraffin-embedded materials, showed a diploid DNA content in the excised verrucous carcinoma and an aneuploid content in the anaplastic tumor. This patient most likely had radiation-induced transformation of an anaplastic carcinoma. Wide excision and, if necessary, amputation, are preferred to radiotherapy.
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9/10. A case of verrucous carcinoma associated with human papillomavirus type 16 DNA.

    We report here a case of verrucous carcinoma which occurred on the penis of a 75-year-old male. The nodule was first noted six months earlier and was whitish, cauliflower-like, and 17 x 19 mm in size. The histopathological examination revealed hypertrophic epidermal proliferation with pale staining keratinocytes, extending into the deep dermis. Partial penectomy and inguinal lymph node dissection were done. No lymph node metastasis was recognized. DNA was isolated from the frozen tumor tissue and examined for the presence of human papillomavirus (HPV) 16, 18, and 33 DNA by the polymerase chain reaction (PCR), using common and specific primers. A 140 base pair (bp) band was amplified and finally determined to be the HPV16 sequence by dot-blot hybridization.
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10/10. Human papilloma virus in verrucus carcinoma of the vulva: an immunopathological study of three cases.

    The pathological features of three cases of verrucus carcinoma of the vulva, examined in our laboratory during the last decade are presented. Verrucus carcinoma of the vulva is of special interest because of its rarity (6.5% of our cases of malignant lesions of the vulva), its special morphology and the problems in differential diagnosis that are encountered. There is also evidence that there is an association with HPV infection. We present the pathological features of three cases of verrucus carcinoma that we studied in the last decade in our Laboratory among 48 malignant lesions of the vulva. An immunohistochemical detection of HPV was performed by the streptavidine-viotine method and classification by in situ hybridization showed the presence of HPV 6/11 in all cases.
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