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Anal verrucous carcinoma is not related to infection with human papillomaviruses and should be distinguished from giant condyloma (Buschke–Löwenstein tumour)
Author(s) -
Zidar Nina,
Langner Cord,
Odar Katarina,
Hošnjak Lea,
Kamarádová Kateřina,
Daum Ondrej,
Pollheimer Marion J,
Košorok Pavle,
Poljak Mario
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13158
Subject(s) - verrucous carcinoma , koilocyte , hpv infection , in situ hybridization , pathology , human papillomavirus , immunohistochemistry , polymerase chain reaction , papillomaviridae , condyloma acuminatum , etiology , medicine , carcinoma , biology , cancer , messenger rna , gene , cervical cancer , cervical intraepithelial neoplasia , biochemistry
Aims Verrucous carcinoma ( VC ) is a variant of well‐differentiated squamous cell carcinoma and in the anal region is regarded as synonymous with giant condyloma (Buschke–Löwenstein tumour) ( BLT ). Aetiology, diagnostic criteria and clinical behaviour of both lesions are controversial. Recent studies suggest that VC at other sites is not associated with human papillomaviruses ( HPV ). We hypothesized that anal VC is also not related to HPV , while BLT is a HPV ‐induced lesion. Methods and results Ten cases of VC and four cases of BLT were included. Several techniques were used for HPV detection: in‐situ hybridization for HPV 6, 11, 16 and 18, six different polymerase chain reaction ( PCR ) protocols for detection of at least 89 HPV types from alpha‐ , beta‐ , gamma‐ and mu‐ PV genera and in‐situ hybridization for high‐risk HPV E6/E7 mRNA ; p16 immunohistochemistry and morphometric analysis were also performed. Alpha‐ , gamma‐ and mu‐ PV s were not found in any case of VC , while HPV 6 was detected in all cases of BLT . p16 overexpression was not present in any of the lesions. Among microscopic features, only the absence of koilocytosis and enlarged spinous cells seem to be useful to distinguish VC from BLT . Conclusions Our results suggest that anal VC , similarly to VC at other sites, is not associated with HPV infection, and must be distinguished from BLT , which is associated with low‐risk HPV . Only with well‐set diagnostic criteria will it be possible to ascertain clinical behaviour and optimal treatment for both lesions.