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At least 19 recordsLinked to original sources
PubMed2004

Condyloma acuminatum and condyloma-like lesions of the oral cavity: a study of 11 cases with an intraductal component.

AIMS: We studied the clinicopathological features of 11 condyloma and condyloma-like lesions of the oral cavity with an unusual mixed pattern of exophytic and intraductal growth. The latter manifest as involvement of minor salivary gland ducts by the proliferative squamous lesions. This pattern of ductal involvement has not been previously described in oral condyloma. METHODS AND RESULTS: The clinical history was available for nine patients ranging in age from 17 to 73 years. Two were female and seven male. The buccal mucosa (five cases) was the most common site of occurrence, followed by the floor of mouth (two cases), lingual frenum (two cases), and hard palate (one case). All lesions exhibited exophytic and intraductal growth. The latter manifested itself as extension of the lesions into the excretory ducts of minor salivary glands. Underlying minor salivary glands, present in many of the excisional biopsy specimens, typically showed changes of obstructive atrophy. The exophytic components of all cases exhibited some degree of parakeratosis, and cryptic invaginations of parakeratin were typically present. Koilocytes were present in seven lesions and were equivocal in four. Mucous cells were present in the intraductal component of all cases and the intraductal component was never keratinized, but often papillary. A mild stromal-based, lymphocytic host response was present in three. A variably prominent neutrophilic infiltrate was present in the exophytic component of eight. Dysplasia was not present in any case. Five of 11 cases were positive with anti-human papillomavirus (HPV) and two of 11 cases were positive for in-situ hybridization probes directed against HPV 6/11. All cases were negative for HPV 16/18 and 13/33/35. CONCLUSIONS: Oral condyloma acuminatum may involve the excretory ducts of minor salivary glands. The diagnosis of oral condyloma acuminatum is difficult, as these lesions share considerable histological overlap with squamous papilloma. Finally, the relationship between these two lesions is incompletely understood.

Adolescent↗
PubMed1993

Condyloma acuminatum with superficial spirochetosis simulating condyloma latum.

We report a case of a 12-year-old boy with a large perianal condyloma. The lesion was found to contain both spirochetes (Warthin-Starry stain) and human papillomavirus types 6 or 11 (in situ hybridization). Because of persistent negative serologies for syphilis and lack of other clinical stigmata of syphilis, the lesion was diagnosed as condyloma acuminatum with secondary involvement by spirochetes of probable intestinal origin. The case demonstrates the potential histologic similarities between condyloma latum and condyloma acuminatum, as well as the pitfalls of using the Warthin-Starry stain to establish the diagnosis of secondary syphilis.

Anus Diseases↗
PubMed1992

[Clinical and pathological differential diagnosis of condyloma and pseudo-condyloma of vulva].

Three hundred and twenty-one biopsies from vulva, comprising 18 cases of condyloma acuminata (5.6%), 202 cases of pseudo-condyloma (62.9%), and 101 cases of non-specific vulvitis (31.5%), are reported. Clinically, most condylomata acuminata appeared as multiple soft papillary and verrucous lesions with local itchiness. The majority of patients with pseudo-condyloma were symptomless but with harbor roe-like warty papulae distributed symmetrically on both labia minora. Histologically, 18 cases of condyloma acuminata presented papillomatosis, parakeratosis, dyskeratosis, acanthosis, basal cell atypical hyperplasia and distinct koilocytosis. Pseudo-condylomata showed papillomatous growth but without atypical hyperplasia of basal cells and distinct koilocytosis.

Adult↗
PubMed1989

Correlation of histology and human papillomavirus DNA detection in condyloma acuminatum and condyloma-like vulvar lesions.

The diagnosis of a vulvar condyloma is made when perinuclear halos are seen with nuclear atypia and binucleate forms (koilocytotic atypia). These changes are most prominent in the granular layer and are associated with the presence of human papillomavirus (HPV). However, these changes may be absent or minimal in patients with papillary vulvar lesions; this situation can thus present diagnostic difficulties. We analyzed the histologic features of 53 biopsies from 48 patients who had vulvar lesions suggestive of condylomata. Of the 26 biopsy specimens with koilocytotic atypia, 20 (77%) had sequences homologous to HPV DNA as detected by Southern blot hybridization analysis using a probe of HPV s 6/11, 16, 18, 31, 35, and 51. In cases where the histologic features were suggestive but not diagnostic of condylomata, because unequivocal koilocytotic atypia was not noted, five of 27 (19%) had detectable HPV DNA. In this latter group, we found no histologic feature to distinguish the cases that had detectable HPV DNA from those that did not. Analysis for HPV DNA by in situ hybridization in the cases that were histologically equivocal for condyloma was uniformly negative. We conclude that there is a marked decrease in the detection rate of the HPV types associated with genital tract neoplasms in vulvar lesions that lack koilocytotic atypia. Southern blot hybridization analysis was the only reliable way to distinguish the "equivocal for condyloma" cases that had HPV from those where HPV DNA was not detected.

Adult↗
PubMed2005

Simultaneous human papillomavirus 6 (HPV 6) -positive condyloma acuminatum, HPV 31-positive Bowen's disease, and non HPV-associated extramammary Paget's disease coexisting within an area presenting clinically as condyloma acuminatum.

An 83-year-old Japanese man presented with multiple verrucous papules clustering on a plaque located on the frontal aspect of the scrotum. Histologically, there were three distinct epithelial changes compatible with condyloma acuminatum, Bowen's disease, and extramammary Paget's disease (EMPD). By in situ hybridization, the zone of condyloma acuminatum was positive for HPV 6 and well demarcated from HPV 31-positive Bowen's disease. EMPD was negative for targeted HPV 6/11/16/18/31/33 probes. Immunohistochemically, Paget's cells expressing cytokeratin 7 were distributed as scattered single cells or clusters mainly in the lower part of the HPV 6/31-positive epithelium. To the best of our knowledge, this is the first reported case of the occurrence of condyloma acuminatum, Bowen's disease, and EMPD within the same lesion.

Aged, 80 and over↗
PubMed1986

Condylomas of the uterine cervix initially interpreted as squamous carcinoma: a report of four cases including a lesion resembling the Buschke-Loewenstein giant condyloma.

The recognition of human papilloma virus (HPV)-induced cervicovaginal condylomatous lesions is in a period of dynamic development. It is estimated that condylomatous involvement of the uterine cervix is epidemic and that is particularly true in the younger, more sexually active woman. While cervical condylomas are often associated with cervical dysplasia, carcinoma in situ, or even invasive carcinoma, they are sometimes misdiagnosed as these entities. Four cases of cervical condylomas are presented that were clinically suspicious for malignancy and initially interpreted as squamous carcinomas on the basis of the histopathological findings.

Adult↗
PubMed1993

[A case of giant condyloma acuminatum. On differential diagnosis of giant condylomas from Buschke-Löwenstein tumors and verrucous carcinoma].

We report on a 67-year-old man with a large papillomatous tumour of the penis clinically resembling verrucous carcinoma. HPV 6 and HPV 11 DNA could be isolated by hybridization techniques. The tumour showed exclusively exophytic growth with anastomosing acanthosis and papillomatosis. Groups of vacuolated cells were present in the spinous and granular layers. Endophytic and destructive proliferations and cytologic criteria of malignancy were absent. This tumor was a giant condyloma acuminatum and not either a Buschke-Löwenstein tumour or a verrucous carcinoma. There was no recurrence 2 years after local excision. The differential diagnosis of giant condylomas and Buschke-Löwenstein tumours is discussed.

Aged↗
PubMed2001

Anal carcinoma arising from condyloma acuminata.

Condyloma acuminata is a common anorectal condition that frequently requires surgical evaluation and treatment. We have noted an increased incidence of anal carcinoma in patients with condyloma acuminata. The purpose of this study is to review the incidence of malignant transformation of condyloma in our recent experience. We conducted a 5-year retrospective review of patients with condyloma acuminata treated at a university medical center that serves as a major referral center for the state. From May 1994 through May 1999 257 patients were treated for anal condyloma. During the same time period 74 patients were diagnosed with squamous cell carcinoma of the anus; nine of these patients also had condyloma acuminata (12.2% of patients with anal carcinoma). All nine were immunosuppressed by illness and/or medication. The extent of carcinoma at diagnosis ranged from stage 0 (carcinoma in situ) to stage IVb. Overall 3.5 per cent of patients with condyloma acuminata also had squamous cell carcinoma of the anus. One patient with stage IVb disease died shortly after initial evaluation. Two patients with advanced disease required extensive surgical intervention and had complex postoperative courses. Malignant transformation of condyloma acuminata may be increasing in incidence. This disease progression can be insidious and may be fatal. Screening of high-risk patients might be of value, and more aggressive early management of condyloma may prevent the development of malignancy.

Adult↗
PubMed1998

Cervical condylomas show higher proliferation than do inflamed or metaplastic cervical squamous epithelium.

Changes of condyloma are sometimes difficult to distinguish from changes seen with inflammation or with squamous metaplasia (SM) in the uterine cervix. Cervical condylomas show increased proliferative activity, so we sought to discover whether this increased activity is more than that seen in SM or with inflammation. Mitotic activity per 10 high power fields was measured in 22 cases with SM, 22 cases with exocervix only, 26 cases with inflammation, and 34 cases with condylomas. The percentage of basal cells staining for MIB-1 was compared between 27 cases with condyloma, 11 cases each with SM and inflammation, and 13 cases with exocervix. Mitotic activity was significantly increased in cervical condylomas (7.6 +/- 6.6, mean +/- standard deviation) compared with SM (1.4 +/- 1.4, P < .0001), inflamed epithelium (1.6 +/- 1.4, P < .0001), and exocervix (1.4 +/- 1.5, P < .0001). More than 15% of basal cells stained for MIB-1 in 18 of the 27 condylomas, 1 of 11 cases with SM, 1 of 11 cases with inflammation, and none of the 13 cases with exocervix (P = .003, .003, and .0006 respectively). Expression of MIB-1 in the surface half of the epithelium was seen in 18 (66%) of the 27 cases with condyloma but in none of the 24 controls (P < .00001). MIB-1 in the surface half of the epithelium and/or in more than 15% of the basal cells was seen in 24 (90%) of the 27 condyloma cases and 1 (4%) of the 24 control cases (P < .00001). A finding of 6 or more mitoses per 10 high power fields, expression of MIB-1 in the surface half of the epithelium, and more than 15% of basal cells staining for MIB-1 should support a diagnosis of condyloma over metaplastic or inflammatory changes.

Antigens, Nuclear↗
PubMed1988

Penile/anal condylomas and squamous cell cancer. A HPV DNA hybridization study.

Acuminate condylomas from the penis (n = 17) and anus (six cases), three anal/penile giant condylomas, anal Bowen's disease (four cases), and intraanal squamous cell carcinomas with associated condylomatous changes (10 cases) including two verrucous carcinoma were studied for human papillomavirus (HPV) infections with nick translated, biotinylated cDNA probes for HPV 6, 11, 16 and 18. In addition, six cases of flat white penile lesions designated as lichen sclerosus et atrophicus were examined. Reannealed complementary DNA strands were detected in situ with either immunoenzyme or immunogold protocols. The in situ hybridizations resulted in 1/6 positive penile lichenoid lesions, 12/17 positive penile acuminate condylomas, 6/6 positive anal acuminate condylomas (including two condylomas with cellular atypias), 2/3 positive giant condylomas, 1/4 positive anal bowenoid lesions, and 4/10 positive keratinized squamous cell carcinomas, two of them being verrucous carcinomas. All penile/anal condylomas and two giant condylomas harboured HPV 6 and/or 11 DNA. The five positive carcinomas (carcinoma in situ/invasive cancer) contained HPV 6 and/or 11 in two cases (including the verrucous carcinomas), and HPV 16 and/or 18 in three cases (one carcinoma in situ, two invasive carcinomas). Recurrent malignancies were seen in one case to harbour the same HPV type as the primary lesions (HPV 16). In one particular patient, a double infection with HPV 16 and HPV 18 was demonstrated in distantly located malignant tumours. Our study confirms the restrictions and the value of non-isotopic hybridization methods applied to archival tissues, and extends the knowledge on the presence and distribution of HPV infections at anogenital sites.

Adult↗
PubMed1995

Autogenous vaccine: the best therapy for perianal condyloma acuminata?

PURPOSE: Treatment of perianal condyloma acuminata is frustrating because most treatment options are fraught with high recurrence rates and patient discomfort. We propose that surgical excision followed by vaccination with an autogenous condyloma acuminata vaccine is the most effective therapy available in primary and recurrent perianal condyloma acuminata. METHODS: Eighty-three patients with perianal condyloma acuminata were treated from 1985 to 1992. Treatment was divided for patients as follows: surgical excision, 20; bichloroacetic acid, 10; podophyllin and interferon A, 5; excision followed by autogenous condyloma acuminata vaccination twice weekly using 0.1 ml subcutaneously for three weeks increasing to 1.0 ml subcutaneously for seven weeks, 43. Syphilis was diagnosed in seven patients; two were human immunovirus-positive. All but three patients were male. Of those patients treated with the vaccination protocol, 25 had primary and 18 had recurrent disease. RESULTS: Recurrence rates were: excision alone and bichloroacetic acid, 50 percent; podophyllin and interferon A, 85 percent; whereas only 4.6 percent recurred when treated with excision and vaccination. Mean follow-up was 13 (range, 6-23) months. All patients treated with the vaccination protocol tolerated the full course of therapy. CONCLUSION: We believe that excision of perianal condyloma acuminata followed by autogenous condyloma acuminata vaccination for approximately ten weeks is the most effective and definitive treatment option and, moreover, should be considered in all patients with perianal condyloma acuminata.

Adult↗
PubMed2005

[Anal condyloma prevalence among HIV infected patients].

BACKGROUND: In the general HIV-infected population, there are few data on the prevalence and risk factors for anal condyloma, precursor lesions for anal cancer. METHODS: Screening for perianal and endoanal condyloma with an anoscopy was systematically proposed to 516 consecutive outpatients, followed in a university hospital in Paris. For each point, HIV characteristics and sexual behaviors assessed through semi-directive questionnaire were collected. FINDINGS: The 473 (92%) examined patients, consisted of 200 homosexual men, 123 heterosexual men, 150 women; 76% were receiving HAART, HIV-RNA was<50 copies/ml in 60%, mean (+/-SD) CD4 cell count were 484 (+/-274)/mm(3). Overall, 108 (23%) pts had histologically-confirmed anal condyloma (36, 15 and 11% of the respective populations), including 51 (47%) pts with only endoanal localisation. Intraepithelial neoplasia of grade I was noted in 59 patients, of grade II in 10 and of grade III in 2 and an invasive endoanal cancer in 1. In multivariate regression analysis, condyloma independent risk factor were history of gonococcia or syphilis (OR=0.54 (0.29-0.99)), and history of previous anal condyloma (OR=2.05 (1.07-3.92) in homosexual men, history of previous penis condyloma (OR=26.8 (2.3-309.6), and unprotected sexual intercourse (OR=7.5 (2.1-26.3)) in heterosexual men and CD4 cell count below 200/mm(3), (OR=8.9 (1.5-51.6)), receptive anal intercourse (OR=6.7 (1.7-25.8)) and history of previous anal condyloma (OR=25.4 (3.4-188.2)) in women. INTERPRETATION: In the HAART era, systematic screening revealed a high rate of anal condyloma in all HIV positive pts (not only in homosexual men). Anal examination should be proposed systematically to all HIV-infected patients.

Antiretroviral Therapy, Highly Active↗
PubMed1998

A comparison of proliferative activity and atypical mitoses in cervical condylomas with various HPV types.

Cervical condylomas associated with HPV types 6/11 rarely progress to dysplasia; this progression is more commonly seen in cervical condylomas with HPV types 16/18/31/33/35. This investigation was undertaken to determine if more frequent atypical mitotic figures (MFs) and higher proliferative activity are seen in high-risk condylomas. HPV types present in cervical condylomas were determined by in situ hybridization with biotinylated probes. The cases were also stained immunohistochemically for MIB1. The percentage staining of basal, parabasal, and suprabasal cells was determined by counting 100 cells in the most intensely stained areas. MFs and atypical MFs were counted per 10 high-power-fields (HPFs). Condylomas with HPV 6/11 showed higher MIB1 expression in the basal layer than condylomas with HPV 16/18 and 31/33/35 (p = 0.013). Atypical MFs were seen more frequently in condylomas with HPV types 16/18/31/33/35 (p = 0.02). Differences in mitotic activity and in MIB1 expression in parabasal and suprabasal layers did not reach statistical significance. The presence of atypical MFs may make a greater contribution than increased proliferative activity to progression to dysplasia in cervical condylomas.

Antigens, Nuclear↗
PubMed2001

Giant condyloma acuminatum of the anorectum: trends in epidemiology and management: report of a case and review of the literature.

PURPOSE: Giant condyloma acuminatum (Buschke-Loewenstein tumor) of the anorectum is a rare disease with a potentially fatal course. Controversy exists as to the epidemiology, pathologic nature, and management of the tumor. METHODS: We present a 42-year-old male with a 12-cm x 10-cm exophytic mass of the anal verge. Treatment included wide local excision and partial closure with rotation flaps. Pathology revealed a giant condyloma acuminatum with foci of well-differentiated squamous-cell carcinoma. We identified 51 reported cases of giant condyloma acuminatum in the English literature, and to our knowledge this is the largest review to date. RESULTS: Giant condyloma acuminatum presents with a 2.7:1 male-to-female ratio. For patients younger than 50 years of age, this ratio is increased to 3.5:1. The mean age at presentation is 43.9 years, 42.9 in males and 46.6 in females (P = 0.44). There seems to be a recent trend toward a younger presentation. The most common presenting symptoms are perianal mass (47 percent), pain (32 percent), abscess or fistula (32 percent), and bleeding (18 percent). Giant condyloma acuminatum has been linked to human papilloma virus and has distinct histologic features. Foci of invasive carcinoma are noted in 50 percent of the reports, "carcinoma in situ" in 8 percent, and no invasion in 42 percent. Historically, treatment strategies have included topical chemotherapy, wide local excision, abdominopelvic resection, and the frequent addition of adjuvant and neoadjuvant systemic chemotherapy and radiation therapy. Recurrence is common. CONCLUSION: There seems to be a trend toward younger age at presentation and male predominance of giant condyloma acuminatum of the anorectum. Foci of invasive cancer within giant condyloma specimens are of uncertain significance and do not seem to correlate with recurrence or prognosis. Local invasion and local recurrence are the major source of morbidity in this disease. Complete excision is the preferred initial therapy when feasible. Wide local excision, fecal diversion, or abdominoperineal resection have been used. Chemotherapy with 5-fluorouracil and focused radiation therapy may be used in certain cases of recurrence or extensive pelvic disease, with unpredictable response. Controlled, prospective, multi-institutional studies are necessary to further define the nature and treatment of this rare disease.

Adult↗