Genital condyloma virus infection following pelvic radiation therapy: report of seven cases

Epidemiology of infections in cancer patients

Although major advances in the care of cancer patients over the past several decades have resulted in improved survival, infectious complications remain a significant cause of morbidity and mortality. To successfully identify, treat, and prevent infections, a comprehensive understanding of risk factors that predispose to infection and of commonly encountered pathogens is necessary. In addition, clinicians must keep abreast of the changing epidemiology of infections in this population. As therapeutic modalities continue to evolve, as established pathogens become increasingly drug resistant, and as new pathogens are discovered, successful management of infections will continue to present challenges in the years to come.

Squamous-cell carcinoma of the pelvis in a giant condyloma acuminatum: use of neoadjuvant chemoradiation and surgical resection: report of a case

A 60-year-old bisexual male was referred to our institution for management of an unresectable squamous-cell carcinoma of the pelvis arising in a giant condyloma acuminatum. He received neoadjuvant chemoradiation consisting of 5-fluorouracil and mitomycin C with concurrent external beam radiation, followed by posterior pelvic exenteration. The surgical specimen had no residual cancer. In situ hybridization was performed using a human papilloma virus omniprobe for human papilloma virus subtypes 6, 11, 16, 18, 31, 33, and 35. Two years after diagnosis the patient is doing well with no evidence of recurrent disease.

Human papilloma virus and carcinoma of the laryngopharynx

The presence of human papillomavirus (HPV) genomes 6, 11, 16 and 33 in 16 patients with laryngopharyngeal carcinomas was examined by means of a polymerase chain reaction. HPV genomes were detected in 75 per cent of cases. In hypopharyngeal carcinoma, HPV 6 and 11 were present in adjacent tissue but absent from the tumour. HPV 16 and 33 were present in 40 per cent of laryngeal tumours and adjacent tissue. These results suggest that HPV 16 and 33 may be closely associated with the development of some laryngopharyngeal carcinomas.

Human papilloma virus (HPV) and carcinomas of the head and neck

Increasing evidence for a causal link between human papilloma virus and carcinomas of the cervix has emerged in recent research. This group of species-specific, epitheliotropic viruses has also been associated with tumours of the head and neck, but the individual reports deal only with relatively small sample numbers. In the present review these reports are considered in relation to the methods employed, and it is concluded that HPV is associated with more than 50% of oral and nasal carcinomas, as well as with carcinomas of the larynx and oesophagus. The clinical relevance and strategies for future work are outlined.

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.