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PubMedDate not supplied

Simultaneous condyloma acuminatum and dysplasia of the uterine cervix.

A population of 116,090 asymptomatic women between the ages of 20 and 40 was examined for the cytologic presence of dysplasia and koilocytosis presumably resulting from condyloma acuminata of the uterine cervix. Subpopulations of 50 women with severe dysplasia and 50 with severe dysplasia and koilocytosis (= condyloma) were selected for a short-term study of progression to carcinoma or carcinoma in situ. The cytologic preparations examined by morphometry to determine the quantitative morphologic characteristics of the epithelial populations in the two groups showed that patients with condyloma and dysplasia had a different population of cells than those with dysplasia alone. Histologic studies showed that there were significantly more mitotic abnormalities in the condylomatous lesions, consistent with viral alterations of mitosis. While short-term follow-up (three to four years) failed to show that patients with both dysplasia and condyloma were at higher risk of developing cancer than patients with dysplasia alone, patients with condyloma of the cervix should be closely followed clinically since they have a higher risk of other cervical abnormalities.

Adult↗
PubMed1993

[Condyloma acuminatum: histopathology and detection of human papilloma virus].

Comparing with the results of HPV DNA detection by PCR, 44 cases of condyloma acuminatum and condyloma-like lesions in female genital tract were studied histopathologically. Among 40 cases formerly diagnosed as condyloma acuminatum or suspicious condyloma acuminatum, all were HPV DNA detectable. HPV6 and HPV11 were found in 4 cases without koilocytes. HPV6 was found in one out of 4 cases formerly diagnosed as pseudocondyloma. The result showed that koilocytes are characteristic and diagnostic, anyhow, undiscovery of these cells still cannot rule out the possibility of condyloma acuminatum.

Adult↗
PubMed1996

Condyloma latum of the toe webs: an unusual manifestation of secondary syphilis. A report of two cases.

The incidence of primary and secondary syphilis in the United States peaked in 1990, exceeding the number of reported cases since 1948. Uncommon manifestations of secondary syphilis seen more frequently in the preantibiotic era may be less well recognized today. One such manifestation is the condyloma latum, or split papule of the toe web. Two patients with condyloma of the toe web are presented and the previous literature is reviewed. Condyloma latum is a common manifestation of secondary syphilis; however, condyloma latum of the toe webs is unusual. Failure to recognize toe web condyloma latum may delay diagnosis and treatment.

Foot Dermatoses↗
PubMed1996

Differentiation of pseudocondyloma of vulva and condyloma acuminata by dot blot hybridization and polymerase chain reaction.

This study differentiated pseudocondyloma of vulva from condyloma acuminata using dot blot hybridization and polymerase chain reaction (PCR). A total of 27 cases of pseudocondyloma of vulva and 65 cases of condyloma acuminata were selected for the study. The genital lesions were examined clinically and were biopsied. Each biopsy was subjected to histological examination and HPV DNA analysis by dot blot hybridization and PCR. Dot blot analysis detected HPV DNA in 19(82.6%) out of 23 cases of condyloma acuminata and 2(25%) out of 8 cases pseudocondyloma of vulvae (P < 0.05). PCR detected HPV DNA in 51(92.7%) out of 55 cases of condyloma acuminata, compared with none in 23 cases of pseudocondyloma (P < 0.001). HPV DNA was present in the majority of condyloma acuminata specimens, HPV 6 and 11 were the predominant types. Peudocondyloma is probably not associated with HPV. PCR was the most sensitive and useful technique for HPV DNA detection.

Adolescent↗
PubMed1977

Variation in the appearance of giant condyloma in an Ungandan series of cases of carcinoma of the penis.

Whole mount sections were made from all amputation specimen of patients treated for carcinoma of the penis in Mulago Hospital, Kampala, Uganda, during a 21-month period in 1968-1970. Among a total of 55 cases four tumors were found which were large, but histologically showed low invasiveness suggestive of absence of metastatic spread. There were two giant condylomas, and two giant condylomas showing possible microinvasion. Two further cases showed a small squamous cell carcinoma together with a giant condyloma in the remainder of tumor. The most chracteristic feature was an orderly, well-circumscribed, expansive downgrowth, leaving little stroma to be seen between the epithelial masses to tumor. Within these limits, however, the spectrum of growth pattern, differentiation, and malignant change was very wide and much more varied than in tumors recorded form Western countries. This should be remembered when a presumptive diagnosis of the condition is to be made on small routine biopsies. Additional changes showing marked similarities to condylomata acuminata were often seen in superficial portions of tumor. This transition in histological picture within one tumor favors the view that giant condyloma is an intermediate lesion in the development of cancer in condylomata acuminata.

Adult↗
PubMed1987

Topographic study of cervical condyloma and intraepithelial neoplasia.

In this study of 101 cervical conization specimens, the location and the size of condyloma and intraepithelial neoplasia (dysplasia and carcinoma in situ) were mapped using the last endocervical gland as the marker for the original squamocolumnar junction. Condylomatous changes were identified in 85% of cervices affected by the intraepithelial neoplasia, and were in direct contact with 68% of intraepithelial neoplasms. The proximal location of intraepithelial neoplasia in relation to the condyloma can be explained by the occurrence of neoplasia just proximal to the condyloma and subsequent expansion of neoplasia towards the cervical canal. This study adds topographic evidence linking cervical condyloma to the development of intraepithelial neoplasia.

Carcinoma in Situ↗
PubMed1990

Influence of human papillomavirus on DNA ploidy determination in genital condylomas.

It has been reported that deoxyribonuclease (DNAse) treatment does not destroy viral DNA, but it does digest native nuclear DNA. To determine what effect, if any, papillomavirus infection has on DNA ploidy values of genitourinary condylomas, DNA was measured with and without DNAse exposure in seven urethral condylomas, shown by prior in situ hybridization to contain abundant human papillomavirus types 6 and 11. Normal human skin was used as a negative control. Consecutive paraffin-embedded tissue sections were stained according to Feulgen before and after DNAse treatment. The DNA was measured by image analysis. In control tissue, DNAse obliterated DNA, and the Feulgen reaction was negative. In six of seven condylomas the DNA content was reduced, but a measurable Feulgen reaction was still present in isolated cells. In the seventh case there were no significant changes in the histograms. This observation strongly suggests that the presence of human papillomavirus has a significant effect on measurements of DNA ploidy in genital condylomas and, by implication, possibly also in other tissues containing the virus. Possible mechanisms are discussed.

Adult↗
PubMed1998

Assessment of archived paraffin-embedded cervical condyloma tissues for mycoplasma-conserved DNA using sensitive PCR-ELISA.

Clinically, it is important to detect mycoplasmas because these organisms have been implicated in gastric and ovarian cancer, pneumonia, postabortal fever, pelvic inflammatory disease, pyelonephritis, endometritis, urethritis, perinatal mortality, arthritis, spontaneous abortion, infertility and interference with sperm development and they act as cofactors catalyzing the HIV disease state. Recently, the combined polymerase chain reaction and enzyme-linked immunosorbent assay method targeting the consensus DNA of over 15 species of mycoplasmas was shown to be superior for the detection of mycoplasmas. The objective was to determine if there was an association between mycoplasmas and cervical neoplasia. Cervical tissues, histopathologically categorized by cervical intraepithelial neoplasia (CIN) grade, flat or exophytic, and acanthosis or koilocytotic, were used. The results showed that mycoplasmas DNA were present in 21.4% of the condyloma tissues and in 33.3% of condyloma tissues with CIN. In contrast, mycoplasmas DNA were not detected when there were no CIN. The presence or absence of human papillomavirus (HPV) did not make a difference. Mycoplasmas DNA were present in 40.0 and 12.5% of the exophytic and flat condylomas, respectively. A higher percentage of cervical tissues graded with slight koilocytosis had (P = 0.05) mycoplasmas DNA compared with tissues graded with moderate koilocytosis. The detection of mycoplasmas DNA in archived cervical condyloma tissues with CIN corroborated previous reports of an association between mycoplasmas and CIN. However, the association between mycoplasmas and the presence of HPV could not be made in this study.

Condylomata Acuminata↗
PubMed1995

Invasive squamous-cell carcinoma in giant anorectal condyloma (Buschke-Löwenstein tumor).

Giant condyloma acuminata, first described by Buschke and Löwenstein in 1925 as a penile lesion, is extremely rare in the anorectal region. The cauliflower-like tumor behaves clinically in a malignant fashion, although it shows no histomorphological criteria of malignancy. Up to the time of writing only 33 cases of anorectal origin, 42% with malignant transformation, have been published. The authors report 2 more cases of squamous-cell carcinoma in giant anorectal condylomata acuminata. Buschke-Löwenstein tumor is an intermediate entity between "ordinary" condyloma acuminata and squamous-cell carcinoma. Benign condyloma acuminata is caused by human papillomavirus 6 or 11. Carcinogenic cofactors promote the transition to giant, locally destructive condyloma acuminata and subsequent malignant transformation. Cure can only be achieved by early and radical excision. Formation of multiple fistulas and destruction of the sphincter may necessitate abdomino-perineal resection. Adjuvant radiation therapy should only be considered to render a tumor operable, as radiation may act as a cocarcinogenic effect and lead to a less differentiated and more aggressive cancer. The small number of cases reported and the variety of treatment regimens applied, however, do not allow the formulation of definitive therapeutic guidelines.

Anal Canal↗
PubMed1987

Patients with condyloma acuminatum exhibit decreased interleukin-2 and interferon gamma production and depressed natural killer activity.

Peripheral blood mononuclear cells were obtained from 20 untreated condyloma acuminatum patients and from an equal number of sex- and age-matched controls and assayed for cell surface antigen expression, natural killer activity, and lymphokine production. Patient peripheral blood mononuclear cells had significantly lower helper-to-suppressor T-cell ratios (Leu3/Leu2) (P less than 0.05) and significantly higher percentages of Leu 2+ Tac+ cells (activated suppressor/cytotoxic cells) (P less than 0.05) and Leu 2+ OKM1+ cells (suppressor cells) (P less than 0.01). Natural killer activity of condyloma acuminatum patients was significantly lower (P less than 0.05) than that of controls. Production of interleukin-2 and interferon gamma, but not interferon alpha, was significantly (P less than 0.01) decreased in condyloma acuminatum patients. There was an inverse correlation between the in vitro production of interleukin-2 and interferon gamma and the percentage of Leu 2+ OKM1+ cells (suppressor) (P less than 0.01). Thus, patients with condyloma acuminatum differ from controls by demonstrating decreased natural killer-cell activity, decreased production of lymphokines which enhance natural killer-cell activity (i.e., interferon gamma and interleukin-2), and an increased proportion of T cells with a suppressor phenotype.

Adult↗
PubMed1994

Giant condyloma acuminatum (Buschke-Lowenstein tumor) of the anorectal and perianal regions. Analysis of 42 cases.

PURPOSE: Giant condyloma acuminatum or Buschke-Loewenstein tumor of the anorectal and perianal regions is an uncommon entity that has not been extensively reviewed. We analyzed 42 known cases of giant condyloma acuminatum in the English literature and reviewed their behavior and management. METHODS: All reported cases of giant condyloma acuminatum in the English literature were selected. The relevant clinicopathologic features of this uncommon entity were examined and discussed. RESULTS: These tumors are generally large with the propensity to ulcerate and infiltrate into deeper tissues. The hallmark of the disease is the high rate of recurrence (66 percent) and malignant transformation (56 percent). No distant metastases have been reported. The overall mortality was 20 percent, all occurring in patients with recurrences. Fifty percent of the patients who were initially treated with radical surgery developed recurrences. The average duration of disease was longer in patients with recurrences than in patients without recurrences (9.6 years vs. 2.8 years). The median number of recurrences was two (range, one to seven) recurrences, and the median time before first recurrence was ten months. Recurrences were treated by radical surgery in 17 patients and chemoradiotherapy +/- local excision in 5 patients. Follow-up information for the remaining five patients was not available. The cure rate in the radical surgery group was 61 percent compared with 25 percent in the chemoradiotherapy +/- local excision group. CONCLUSIONS: Giant condyloma acuminatum of the anorectal and perianal regions is a highly aggressive tumor with the propensity for recurrences and malignant transformation, but without metastatic potential. A high rate of recurrence is seen in patients with long duration of the disease. Salvage of patients with recurrences can be achieved successfully with radical surgery.

Adult↗
PubMed1994

Adjuvant interferon for anal condyloma. A prospective, randomized trial.

PURPOSE: The aim of this study was to determine whether interferon combined with surgical excision and fulguration could reduce the unacceptably high rate of recurrence of anal condyloma seen after surgical extirpation. METHODS: Forty-three patients with anal condyloma were prospectively randomized into two groups. Group I (n = 25) patients underwent surgical excision and fulguration immediately followed by an injection of 500,000 IU (0.1 ml) of interferon alfa-n3 into each quadrant of the anal canal. Group II (n = 18) patients underwent surgical excision and fulguration but then received four injections (0.1 ml) of saline into each quadrant of the anal canal. RESULTS: After a mean follow-up of 3.8 months, 10 of 43 (23 percent) patients developed recurrent anal condyloma. Only 3 of 25 (12 percent) interferon-treated patients had recurrences vs. 7 recurrences in 18 (39 percent) saline-treated patients (P = 0.046). Interferon was particularly effective in reducing recurrences in patients whose condylomata were present for more than six months (P = 0.04) and those condylomata that contained human papillomavirus DNA subtype 6/11 (P = 0.05). CONCLUSION: Adjuvant interferon treatment can reduce the high recurrence rate of anal condyloma seen after surgical extirpation.

Adult↗
PubMed1989

Malignant transformation of anorectal giant condyloma acuminatum (Buschke-Loewenstein tumor).

Giant condyloma acuminatum, originally described by Buschke and Loewenstein in 1925 as a lesion of the penis, is more rarely seen in the anorectum and is characterized by clinical malignancy in the face of histologic benignity; however, malignant transformation to frankly invasive squamous-cell carcinoma has been described. Malignant transformation has been reported in 15 patients with "ordinary" condylomata acuminata as well. Twenty giant condylomata acuminata have been previously reported, six of which (30 percent) went on to develop squamous-cell carcinoma. The authors report eight cases of giant condylomata acuminata with invasive squamous-cell carcinoma developing in four patients. Light and electron microscopic methods were used to verify the diagnosis of squamous-cell carcinoma and/or giant condyloma acuminatum in our cases. Human papillomavirus (HPV), known to cause condylomata acuminata, is also known to induce these tumors. The authors support the hypothesis that giant condyloma acuminatum represents an intermediate lesion in a pathologic continuum from condyloma acuminatum to squamous-cell carcinoma. These lesions have a propensity for recurrence, likelihood of malignant transformation, and significant mortality. Therefore, early and radical local excision, and in cases of recurrence, invasion, or malignant transformation, abdominoperineal resection, along with vigilant follow-up, provides the only current hope for cure.

Adult↗
PubMed1988

Recurrent condyloma acuminatum in women over age 40: association with immunosuppression and malignant disease.

Sixteen women aged greater than or equal to 40 years were studied within a total population of 77 women with recalcitrant condyloma acuminatum. Six of the 16 women (38%) were found to have coincident malignant disease (p less than 0.001). Three of these had lymphoma (non-Hodgkin's), two had squamous cell cancer of the vulva or vagina, and one had breast carcinoma. Two of the three patients with lymphoma had recurrent genital condyloma diagnosed before the coexistent lymphoproliferative disorder was discovered. In all, 11 of 16 patients had dysplasia and neoplasia. Seven of the women had other medical conditions associated with immunosuppression. We conclude that the presence of recurrent condyloma acuminatum in women greater than or equal to 40 years of age should lead to examination for the presence of immunosuppression and its underlying cause. A high index of suspicion for concomitant genital squamous cell neoplasia and lymphoproliferative disorders should be realized. The factors relating age, recurrent condyloma, immunosuppression, and malignant disease are discussed.

Adult↗
PubMed1985

Condyloma acuminata in children.

Condyloma Acuminata (venereal warts) are sexually transmitted involving the human papilloma virus. It has become commoner in adults in the last decade. While infection is most often by sexual intercourse, it can be transmitted at birth and with close contact with infected individuals. It is common in marked sexual promiscuity. Condyloma acuminata in children should alert the physician to the possibility of sexual abuse or early sexual activity. We report 14 cases of condyloma acuminata in children; from 6 months to 17 years. Sex incidence was equal. All had social and family problems in common, except for one who developed perianal condyloma after repeated rectal dilatations because of a pull through procedure for Hirschsprung's Disease. Two cases of sexual abuse were documented. Treatment methods included podophyllin, liquid nitrogen, 5 fluorouracil cream, fulguration and laser therapy. An adequate social history was available only in six cases. Investigations should include VDRL and cultures for Gonococcus, careful medical and social history for neglect or abuse.

Adolescent↗
PubMed1989

Human papillomavirus typing of penile condyloma.

Infection with human papillomavirus has been identified as a significant risk factor for the development of cervical neoplasia. Knowledge of the characteristics of infecting human papillomavirus in male patients is lacking. We studied 37 men who presented with genital condyloma to identify the clinical appearance of the lesion, histological features and human papillomavirus type as determined by deoxyribonucleic acid molecular hybridization analysis. Of the patients 32 had penile shaft condyloma: 23 noticed the lesion themselves and 9 presented because the partner had condyloma. An adequate amount of deoxyribonucleic acid was available for analysis in 26 men. Lesions were caused by human papillomavirus types 6, 11 and 31, and uncharacterized types. Five patients had penile shaft and urethral condyloma. In 4 patients infection was caused by more than 1 type or subtype. Neither clinical nor histological features could reliably predict the infecting human papillomavirus type.

Adult↗
PubMed1997

Increased prevalence of vulvovaginal condyloma and vulvar intraepithelial neoplasia in women infected with the human immunodeficiency virus.

OBJECTIVE: To compare the prevalence of human papillomavirus (HPV)-associated vulvovaginal lesions in human immunodeficiency virus (HIV)-positive and HIV-negative women. METHODS: For this cross-sectional study, all participants received a complete gynecologic examination including colposcopic evaluation and a structured interview about sociodemographic characteristics and risk factors for vulvovaginal disease. In addition, HPV DNA was assayed for in cervicovaginal lavages using polymerase chain reaction. RESULTS: Vulvar and/or vaginal condyloma acuminata were detected in 22 of 396 (5.6%) HIV-positive and in 3 of 375 (0.8%) HIV-negative women (odds ratio [OR] 7.3, P < .001). High-grade vulvar intraepithelial neoplasia (VIN) was present in two of the HIV-positive and none of the HIV-negative women. Human immunodeficiency virus-positive women with condyloma or VIN were significantly more likely to have cervical intraepithelial neoplasia (33%) than those without vulvovaginal lesions (17%) (OR 2.9, 95% confidence interval [CI] 1.1, 74). In multivariate logistic regression analysis, both HIV seropositivity (adjusted OR 5.3, 95% CI 1.3, 35.3) and HPV infection (adjusted OR 6.1, 95% CI 1.7, 39.4) were associated with vulvovaginal condyloma. CONCLUSION: The prevalence of vulvovaginal condyloma was increased in HIV-positive women even when controlling for HPV infection. Human papillomavirus-associated disease was more likely to be multicentric and involve the vulva, vagina, and cervix in HIV-positive than HIV-negative women. Detection of high-grade VIN in two of the HIV-positive women suggests that they may also be at risk for developing invasive vulvar carcinoma.

AIDS-Related Opportunistic Infections↗
PubMed2000

Giant-sized condyloma of the breast with focal acantholytic changes.

BACKGROUND: A healthy 26-year-old pregnant woman presented with a 6.0-cm exophytic mass in her left inframammary fold. The lesion was surgically excised. METHODS: Histopathologic sections of the skin lesion were reviewed in hematoxylin and eosin-stained slides. Additional sections were studied by an in situ hybridization method for human papillomavirus DNA (HPV) types 6 and 11. RESULTS: The histopathologic examination demonstrated a benign exophytic, verrucous and papillary epidermal proliferation with features of condyloma acuminatum. Reactivity to HPV DNA types 6 and 11 was demonstrated by in situ hybridization method. The epidermis adjacent to, and focally within, the neoplasm showed multiple areas of suprabasilar and intraepidermal acantholysis without dyskeratosis. CONCLUSIONS: Condylomas related to HPV 6 and 11 may be found in extragenital locations including conjunctiva, oral and nasal mucosa. To our knowledge, however, the extragenital condylomas described in the literature have not included the giant-sized variant. We describe an example of a benign, giant-sized condyloma acuminatum of the breast with nearby acantholytic alterations similar to Hailey-Hailey disease.

Adult↗