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PubMed1995

Report of a case with giant condyloma (Buschke-Löwenstein tumor) localized in the bladder.

Giant condyloma is a variation of condylomata acuminata caused by a sexually transmitted virus infection. Although it is a benign disease, it carries a risk of malignant transformation. Primary locations of giant condyloma are the perianal region and the external genitalia. Bladder involvement is rare. We report on a patient with multiple sclerosis in whom a giant condyloma developed in the bladder. Systemic immunosuppression for the treatment of multiple sclerosis and/or chronic cystitis as a result of neurogenic bladder dysfunction might be a risk factor for the development of giant condyloma of the bladder.

Adult↗
PubMed1994

[A case report of condyloma acuminatum in female urethra].

A case of condyloma acuminatum in female urethra is reported. A 53-year-old woman was referred to our clinic because of urethral bleeding. A tumor was noted around the external urethral meatus and the size of the tumor was 20 mm in diameter. Excision was performed on the tumor including the external urethral meatus. Pathological examination revealed condyloma acuminatum. Condyloma acuminatum in female urethra is very rare. We reviewed and discussed 6 cases of condyloma acuminatum in female urethra, including our case, in the Japanese literature.

Condylomata Acuminata↗
PubMed1994

[Condyloma acuminatum in female urethra: a case report].

A case of female intraurethral condyloma acuminata is present in this report. A 52-year-old woman visited our hospital with the chief complaint of miction pain and bloody secretions. Thirty seven years previously, she had had a pudental tumor resected which was diagnosed as condyloma acuminata. Physical examination revealed two child-finger-head sized, polypoid tumors which arose from about 5 mm inside the external urethral orifice. Laboratory findings were negative for rapid plasma reagin card test (RPR), positive for treponema pallidum hemagglutination test (TPHA) and Trichomonas vaginalis in urine and vaginal secretion. Under the clinical diagnosis of condyloma acuminata, the tumors were resected. Histological examination revealed koilocytosis with mild dysplasia. The histochemical analysis of human papillomavirus (HPV) by in situ hybridization revealed positive for HPV type 31/33/51 and negative for HPV type 6/11 and 16/18. Histological examinations confirmed that the tumors were condyloma acuminata. No recurrence was seen at the 7th post-operative month.

Condylomata Acuminata↗
PubMed1993

[Urethral condyloma acuminatum with severe dysplasia in a male patient detected human papillomavirus type 11: a case report].

We report a case of urethral condyloma acuminatum with severe dysplasia detected human papillomavirus (HPV) type 11. A 47-year-old male patient visited St. Luke's International Hospital complaining of tumor at the urethral meatus. One small papillary lesion was found and excised. Histopathological examination revealed condyloma acuminatum with severe dysplasia. Immunohistochemical detection for HPV antigen in the specimen of condyloma acuminatum was positive and that of severe dysplasia was negative. In an electron microscopical study, viral particles were demonstrated only in the specimen of condyloma acuminatum. Detection of HPV DNA was performed using in situ hybridization (ISH) and southern blot hybridization (SBH). HPV type 11 was found in both lesions. In conclusion, although previous studies have shown that HPV type 16/18 was especially correlated with genital severe dysplasia and carcinoma, the process of malignant transformation was suggested in the association with HPV type 11.

Condylomata Acuminata↗
PubMed1993

[The value of hybridization-in-situ technique in the diagnosis of condyloma acuminatum].

By using 35S-dCTP labelled HPV16 probe, the HPV DNA sequence in 32 cases of condyloma acuminatum and suspicious condyloma acuminatum of vulva and vagina as well as 18 cases of papillomas at different anatomical sites were detected. The results showed that the HPV DNA sequences were positive in all 25 cases of condyloma acuminata which were typical both clinically and pathologically and in 6/7 of the suspicious cases; whereas in only 1/18 of the papillomas at various sites were they positive. Thus, nucleic acid hybridization-in-situ technique combined with histopathology seemed to be of great value for the diagnosis and differential diagnosis of condyloma acuminatum.

Condylomata Acuminata↗
PubMedDate not supplied

[Risk factors for uterine cervix condyloma in sexually active adolescent women].

Factors most commonly associated with cervical cancer are early start of sexual activity and papillomavirus infection. PURPOSE--Studying risk factors for cervical condyloma in sexually active adolescents in the region of Campinas, SP, Brazil. METHOD--131 adolescents with condyloma and 131 without disease, controlled by age and pregnancy state, were compared according to social-demographical, sexual-behavioral and gynecological/obstetrical variables. Relative risk evaluation was performed for each variable and multivariate analysis with logistic regression was made to determine confunding factors. RESULTS--Tobacco smoking and nulliparity were identified as independent risk factors for cervical condyloma in this population. More than two sexual partners and low level of schooling were identified as risk factors in the univariate analysis, however, these factors were highly correlated with tobacco smoking and parity, respectively. All other variables were similar in both groups. CONCLUSION--Although tobacco smoking and nulliparity were identified as risk factors for cervical condyloma, it is very difficult to characterize a sexually active adolescent group without risk for infection.

Adolescent↗
PubMed1995

[Evaluation of sexual abuse in an infant with condyloma acuminatum].

Condyloma acuminatum is a skin infection affecting the anogenital area caused by the human papilloma virus and is usually sexually transmitted in adults. The disease in children is rare and the mode of transmission is controversial. Because of the possibility that children with condyloma acuminatum have been sexually abused, a thorough medical and social evaluation is essential. However, the physician should bear in mind the possibility of nonsexual transmission. Effective management of condyloma acuminatum in prepubertal children involves a multidisciplinary approach and cooperation. We present an 11-month-old girl with genital lesions of condyloma acuminatum. Similar lesions were found in her father's penile area. These findings suggested the possibility of sexual abuse as the cause of the infection. However, detailed, meticulous investigation of the case did not support this suspicion. Our final impression was that transmission was probably nonsexual, as there was no evidence for sexual abuse.

Adult↗
PubMed1996

[Comparison of human papilloma virus-DNA in condyloma acuminatum, cervical cancer and the female genital tract].

OBJECTIVE: To examine human papilloma virus (HPV) infection rate and types in several lesions of the genital tract and to observe the relation between HPV and host cells for differential handling of cases and for early diagnosis. METHODS: Tissues from 89 cases of condyloma acuminata, 76 cases of cervical cancer and swabs from 198 cases of normal vaginal were analysed by polymerase chain reaction for HPV infective rate. Main HPV types were compared and Southern blot was used to compare the physical pattern of HPV in condyloma acuminata and cervical cancer. RESULTS: The positive rates of HPV-DNA in condyloma acuminata and cervical cancer were respectively 98.9% and 94.7%. The primary types of the former were HPV 6, 11 and of the latter mainly 16 and 18. The latent infective rates in normal vagina was 37.4%, among which, HPV 6, 11, 16, 18 consisted of only 21.6%. HPV11-DNA in condyloma acuminata existed mainly in episodic form. Most of HPV16-DNA in cervical cancer integrates into the host cells with variation. CONCLUSIONS: The different types of HPV are related to particular morphology and characteristics of lesions. The relation of HPV-DNA to host cell and can offer some reference for the determination of the character of the lesion, and it may be award of malignant transformation.

Adolescent↗
PubMed1982

Condyloma acuminata in children.

The problem of condyloma acuminata in prepubertal children seems to be more common today than in the past. Transmission of the etiology virus may occur during delivery, from close family contact, or from sexual encounters. Thirty cases of condyloma acuminata in young children have been reported, to which we add four new cases. This article reviews the 34 cases with regard to age and sex, the nature and location of the lesions, and the mode of transmission of the virus. Various modes of therapy are discussed. Because of the possibility that children with condyloma acuminata have been sexually abused, a thorough medical and social evaluation is essential.

Anal Canal↗
PubMed1983

Histologic, nuclear DNA, and human papillomavirus studies of cervical condylomas.

Fifty-four cervical condylomatous lesions, with and without nuclear atypia, from 42 women, were studied with the Feulgen microspectrophotometric technique for nuclear DNA quantitation and an immunoperoxidase technique for human papillomavirus (HPV) antigen. All ordinary cervical condylomas (without atypia/dysplasia) had a diploid or polyploid nuclear DNA distribution; 61% had detectable HPV antigen. Among the cervical condylomas with atypia/dysplasia, 55% (17/31) had diploid or polyploid nuclear DNA pattern, and, of these, 59% (10/17) had demonstrable papillomavirus antigen. Fourteen (45%) were aneuploid lesions, 2 of which had a small number of cells with papillomavirus antigen (14%). These findings suggest that the majority of cervical condylomas are related to papillomavirus infection. That lesions with dysplasia, including high degrees of dysplasia, may also exhibit coexistence of papillomavirus infection suggests the possibility of an infectious etiology in the genesis of cervical squamous neoplasia.

Adolescent↗
PubMed1984

Flow cytometric DNA analysis as a diagnostic aid for cervical condyloma and cancer.

Flow cytometric DNA analysis data (FCDA) were obtained from 324 samples provided through the Gynecology-Oncology Clinic. These samples consisted of 294 combined endoectocervical and vaginal smears and 30 peritoneal washings. Using a conventional scheme for G0/G1, S + G2/M and the coefficient of variation with computer correction for the cell-cycle kinetics, it was possible to assign a diagnostic Class I, II, III or V similar to that used by the Cytology Laboratory. These data were then compared with the histopathologic and colposcopic diagnoses. The correlation between FCDA and cytologic results were essentially similar to the previous data obtained from only endocervical sampling. The most interesting finding in this study was the recognition of an FCDA pattern showing a higher DNA content in the G0/G1 and the early S regions in 70 of 94 (74.5%) of samples from patients with condyloma acuminata. All condyloma samples were diagnosed either by cytologic, histopathologic, or colposcopic examination, or a combination of two or three. All biopsy specimens were then reviewed by one pathologist to verify any discrepancies. The relationship of this pattern to the viral etiology of this disease is discussed with the three methods of diagnosis and electron microscopic observations. It is suggested that, based on this study. FCDA analysis of pap smears may also be useful in determining the presence of condyloma in a gynecology clinic. The potential value of FCDA analysis from peritoneal washings for the diagnosis of gynecologic cancer can not be ascertained in this preliminary investigation because of insufficient samples.

Cell Cycle↗
PubMed1986

Cytologic detection of condylomas and cervical intraepithelial neoplasia of the uterine cervix with histologic correlation.

Human papillomavirus (HPV) has been implicated as an important etiologic factor in cervical carcinoma. This study evaluates the efficacy of cytology as a screening tool in the detection of cervical lesions with koilocytotic features. Cervical smears and biopsy specimens from 76 women seen between January 1983 and October 1985 were reviewed. The histologic categories consisted of koilocytotic lesions (flat condylomas) with minimal cellular atypia, CIN I, II, III, with surface koilocytes showing cellular atypia (atypical koilocytosis), CIN III with a contiguous lesion as defined in categories 1 and 2, negative biopsies. Histologically, five cases showed flat condylomas with minimal cellular atypia, 65 showed cervical intraepithelial neoplasia (CIN) with atypical koilocytosis and two showed negative biopsies. Cytologically, in all cases of flat condyloma with minimal cellular atypia (5+5), CIN I with atypical koilocytosis (39/39), and CIN III with a contiguous condylomatous lesion (4/4) both koilocytes and, in the latter two categories, dysplastic cells were identified in the cervical smears. In 7/9 cases of CIN II and 9/17 cases of CIN III with atypical koilocytosis, smears showed both atypical koilocytes and dysplastic cells. In the remaining ten cases, however, there was cytologic underestimation of the histologic diagnosis of CIN, particularly when the lesion was focal. The data suggests that although cytology does detect a high percentage of cervical lesions with koilocytotic features (64/76, 84% in this study), it may not detect focal CIN II, CIN III lesions associated with condylomatous lesions in the same biopsy specimen. Therefore, it is proposed that all women with cytologic evidence of koilocytosis on cervical smears are deserving of a colposcopic examination.

Adolescent↗
PubMed1990

Monoclonal antibody against a tumor-associated sialoglycoprotein of superficial papillary bladder tumors and cervical condylomas.

A mouse IgG1 monoclonal antibody (MAb), 19A211, defining a tumor-associated cell-surface antigen of superficial papillary bladder tumors, was generated by immunizing with fresh bladder tumor cells mice neonatally injected with normal human urothelial cells. The reactivity of the antibody with cell lines was examined by indirect immunofluorescence staining and was restricted to 3/14 bladder cancer lines and 3/31 cancer cell lines of non-bladder origin, including HeLa cervical cancer. No normal fibroblast, kidney cells, EBV-lymphocytes, erythrocytes or leukocytes expressed the antigen. Reactivity of MAb 19A211 was well preserved on tissue paraffin sections. Immunoperoxidase staining of normal adult or fetal tissues showed no reactivity except for a patchy or uniform staining of umbrella cells in 6/23 adult and 1/4 fetal urothelium samples. Positive and often heterogeneous staining was observed on 24/38 papillary superficial tumors (Ta) and 4/5 carcinoma in situ bladder lesions but on only 4/20 infiltrating tumors. It was also observed on 5/6 cervical condylomas and one bladder condyloma, but none of 6 penile or vulvar condylomas. All other tumors tested were negative. The antigenic determinant is present on a heterogeneous group of proteins with molecular weights ranging from 90 to 200 kDa. It is sensitive to periodate treatment and to neuraminidase but only partially sensitive to proteases. MAb 19A211 is different from other reported MAbs with similar reactivity to superficial bladder tumors and umbrella cells of normal urothelium. When tested in competition assays, several of these MAbs, but not 19A211, were found to react with Lewis X blood group determinant. Our results suggest that 19A211 may be useful for detection and stratification of bladder tumors.

Antibodies, Monoclonal↗
PubMed1993

Evolution of the antibody response to human papillomavirus type 11 (HPV-11) in patients with condyloma acuminatum according to treatment response.

To evaluate the variation over time of seroreactivity to human papillomavirus type 11 (HPV-11) according to disease outcome, we selected a sample of 42 condyloma acuminatum patients from a group of subjects enrolled in a placebo-controlled trial of three alpha-interferon preparations administered parenterally for the treatment of condyloma acuminatum. This sample included 14 subjects who were cured by the end of follow-up (cured group) and 28 subjects who were not (failed group). For each individual, the first and last sera collected in the study were tested with an intact HPV-11 virion-based enzyme linked immunosorbent assay (ELISA). The sera of 20 nuns with no lifetime sexual exposure served as controls. The median optical density (OD) value of the first serum samples (as well as that of the last samples) from the patients, 0.155, was higher than that of the control sera, 0.073 (P = 2 x 10(-4)). Sensitivity of the assay was 50%. To test if evolution of seroreactivity in the seropositive patients was related to disease outcome after treatment, we examined the average percentage of daily change in OD between the two serum collections. The median OD in the cured group (n = 7) dropped by 0.05% a day whereas in the failed group (n = 11) it increased by 0.07% a day, a highly statistically significant difference (P = 0.006). It is concluded that changes in the seroreactivity to HPV-11 virions are related to outcome of condyloma acumination after treatment. Therefore, improved serological assays may eventually contribute to the monitoring of HPV disease activity.

Adult↗
PubMed1982

Giant and recurrent condyloma acuminatum: appraisal of immunotherapy.

Eighty-four cases of condyloma acuminatum were presented, with conventional treatment, e.g., surgical excision and fulguration with or without Podophyllin application. Recurrence rate was 28 per cent to 65 per cent, depending on the number and duration of treatments. Immunotherapy was used on 17 patients with recurrent and giant condyloma acuminatum. Condylomata were successfully eradicated in 94.1 per cent of patients, which indicates that immunotherapy is a very effective alternative in the treatment of recurrent and giant condyloma acuminatum.

Adolescent↗
PubMed1980

Malignant potential of perianal condyloma acuminatum.

Perianal condyloma is usually a benign disease, but may become locally aggressive; carcinomatous change may occur. This disease could be potentially malignant, and if malignant transformation occurs the treatment should include abdominoperineal resection. Perianal condylomas in association with anal fistula show malignant behavior; should such malignant behavior develop in perianal condyloma, the disease should be treated aggressively with excision and immunotherapy. Abdominoperineal resection may be necessary.

Adult↗
PubMed1981

Malignant transformation of perianal condyloma acuminatum: a case report with review of the literature.

A case of squamous-cell carcinoma arising in association with perianal condyloma acuminatum was studied by light microscopy. The eight previously reported cases of malignant transformation of perianal and anorectal condylomata acuminatum are reviewed and the salient features described. Light microscopic examination of the case reported here demonstrated several foci of subtle and abrupt transition from condyloma acuminatum to epithelial dysplasia and to carcinoma in situ with focal frank invasion. This study further substantiates the existence of malignant transformation of condyloma acuminatum, particularly in perianal skin.

Anus Neoplasms↗
PubMed2004

Excision and V-Y plasty reconstruction for giant condyloma acuminatum.

BACKGROUND: Condyloma acuminata is the most common anorectal lesion in patients infected with human immunodeficiency virus (HIV). Surgical treatment can be challenging in cases where the size and extension into the anal canal make individual excision impossible. These patients require large resections and reconstruction using grafts or local flaps. METHODS: Six patients were treated for giant perianal condylomas between 1999 and 2001. Four patients were HIV-positive, and were selected for surgical intervention after achieving a T4 count >350 and low viral replication. In 5 cases, the lesions were circularly resected up to the pectinate line and the defect was reconstructed using a bilateral V-Y plasty. In the remaining case, fulguration was possible on one side and a unilateral V-Y plasty was performed. RESULTS: There were no infections or healing delays in this series, and the functional and aesthetic results are satisfactory. CONCLUSION: V-Y plasties are a valid method for perianal reconstruction after resection of giant anal condyloma, with good results in selected patients with HIV infection.

Adolescent↗