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Grosu-Bularda A, Hariga CS, Dumitru CS, Calcaianu N, Creanga CA, Enache V, Tache SE, Bordeanu-Diaconescu EM, Ratoiu VA, Teodoreanu RN, Lascar I. Clinicopathological Findings and Comprehensive Review of Buschke-Lowenstein Tumors Based on a Case Study. J Pers Med 2024; 14:887. [PMID: 39202078 PMCID: PMC11355402 DOI: 10.3390/jpm14080887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/14/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
The Buschke-Löwenstein tumor (BLT), also known as giant condyloma acuminatum, is a rare, exophytic tumor, arising from pre-existing warty lesions associated with human papillomavirus (HPV) infection, particularly strains 6 and 11, which are considered to have low oncogenic potential. BLT presents as a large, cauliflower-like growth typically affecting the penis, vulva, vagina, perineum, scrotum, anus, and perianal area. Despite being a benign lesion, BLT is locally aggressive with a high recurrence rate, and can potentially undergo malignant transformation into squamous cell carcinoma, contributing to an overall mortality rate of 20-30%. The primary treatment is complete surgical excision with wide margins, frequently requiring complex reconstructive techniques for defect coverage. We report on a 68-year-old patient, with multiple comorbidities, who presented with a two-year history of a large exophytic tumor in the genital region, affecting the penis, along with progressive erectile dysfunction and urinary problems. The tumor was surgically excised with oncological safety margins, and reconstruction was performed using advancement and rotation flaps from the scrotum and intact penile skin. Histopathological examination confirmed the diagnosis of Giant Condyloma (Buschke-Löwenstein tumor), showing acanthosis, papillomatosis, parakeratosis, and koilocytic cell collections, with positive immunohistochemical staining for p16, p63, and ki67. Postoperatively, the patient had a good clinical outcome and a complete surgical cure. This case highlights the critical need for timely intervention and comprehensive management strategies in treating giant condyloma, given its potential for local invasion and substantial impacts on patient quality of life. Early diagnosis and thorough surgical excision are crucial for effective management and to reduce the high recurrence, morbidity and malignant transformation risk associated with this condition.
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Affiliation(s)
- Andreea Grosu-Bularda
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (A.G.-B.)
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Cristian-Sorin Hariga
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (A.G.-B.)
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Catalina-Stefania Dumitru
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Nicolae Calcaianu
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (A.G.-B.)
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Cosmin-Antoniu Creanga
- Department of Anatomical Pathology, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Valentin Enache
- Department of Anatomical Pathology, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Silvia-Elena Tache
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Eliza-Maria Bordeanu-Diaconescu
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Vladut-Alin Ratoiu
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Razvan-Nicolae Teodoreanu
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (A.G.-B.)
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Ioan Lascar
- Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania; (A.G.-B.)
- Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
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Soleimani-Jelodar R, Arashkia A, Shoja Z, Sharifian K, Akhavan S, Yarandi F, Jalilvand S. Type-specific human papillomavirus prevalence in women referred for colposcopy in Tehran. IRANIAN JOURNAL OF MICROBIOLOGY 2024; 16:421-427. [PMID: 39005605 PMCID: PMC11245344 DOI: 10.18502/ijm.v16i3.15799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Background and Objectives Although several studies have been achieved on the frequency of the HPV types among women with cervical cancer in Iran, HPV-positive samples were in some cases directed to specific-primer genotyping of HPV 16 and 18. Therefore, the other HPV types are underestimated. Several studies have also reported a greater prevalence of HPV 16 in cervical cancer in Iran than in the world. To clarify these subjects, the distribution of HPV types in women referred for colposcopy in Tehran was investigated. Materials and Methods In this cross-sectional study, a total of 148 cervical samples from women with normal, atypical squamous cells of undetermined significance, cervical intraepithelial neoplasia I-III, and invasive cervical cancer histopathology were included. HPV was detected by PCR assay and all HPV-positive specimens were subjected to direct nucleotide sequencing. Results Our results demonstrated that the total prevalence of HPV was 92.5%. The five most common HPV types were HPV 16 (49.3%), 18 (14.8%), 6 (7.4%), 31 (4.1%), and 11 (2.7%). About the histopathological stage, HPV 16 and 18 were dominant in all studied groups. In cervical cancer, HPV 16 and 18 were detected in 60% and 20% of cases, respectively. Conclusion HPV 16 and 18 were the most common in cervical cancer in Iran.
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Affiliation(s)
- Rahim Soleimani-Jelodar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Arashkia
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Kimia Sharifian
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Akhavan
- Department of Gynecology Oncology, Imam Khomeini Hospital Complex, Valiasr Hospital Tehran, Iran
| | - Fariba Yarandi
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Onwuamah CK, Feng N, Momoh AE, Uwandu M, Ahmed RA, Idigbe I, Vincent GD, Ogbu CA, Okonkwo N, Sokei J, Abimbola BS, Ojopagogo T, Okoli LC, Adesina M, Ezemelue PN, Sowunmi O, Okwuzu J, Labo−Popoola OH, Shaibu JO, Ohihoin GA, Nzeribe E, David A, Olaleye O, Ofotokun I, Dong X, Ezechi OC. Prevalence and risk factors for high-risk human papillomavirus infection among women from three southern geopolitical zones of Nigeria. Front Oncol 2023; 13:1254304. [PMID: 37876969 PMCID: PMC10593479 DOI: 10.3389/fonc.2023.1254304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/19/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Human Papillomavirus (HPV) infection is a risk factor for cervical cancer, the fourth most common cancer among women globally. Its burden is the highest in sub-Saharan Africa, with over 90% mortality. Interventions may fail without evidence-based data on stratified prevalence and risk factors among most at-risk women across Nigeria. Methods A cross-sectional comparative study, with participants recruited from the Nigerian Institute of Medical Research's Clinics, NGO outreaches, a cancer screening centre and a university teaching hospital. Questionnaires were self-administered. Trained medics performed sampling at healthcare facilities, and self-sampling was used at outreaches. Results Nine hundred eighty-five study participants were recruited. About 37% and 27% of the women knew about HPV and its vaccines, respectively, but only 6% confirmed vaccination with HPV vaccines. HPV prevalence was highest among women with unknown marital status (35.9%), single women (33.8%), widowed/divorced/separated women (30.3%), and married/cohabiting women (19.6%). HPV infection was significantly higher among women who take alcohol (odds=1.7 [95% CI: 1.2-2.4]) and women who smoke (odds=2.6 [95% CI: 1.4 - 4.6]. HPV strains detected included HPV16 (1.3%), HPV18 (1.5%), Low Risk (0.2%) and Other High-Risk groups (19.7%). Conclusion The inverse relationship between prevalence and education suggests interventions improving awareness and prevention would be impactful. Such interventions could also target HIV-positive women, women presenting with sexually-transmitted infections, who smoke and frequently drink alcohol.
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Affiliation(s)
- Chika Kingsley Onwuamah
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Ning Feng
- Center for Global Public Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Abidemi Esther Momoh
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Mabel Uwandu
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Rahaman Ademolu Ahmed
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
- Division of Allergy and Clinical Immunology, Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Ifeoma Idigbe
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
| | - Grace Deborah Vincent
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chinenye Angela Ogbu
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Nkem Okonkwo
- Department of Obstetrics and Gynaecology, Delta State University Teaching Hospital, Oghara, Delta, Nigeria
| | - Judith Sokei
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Pediatric Oncology (Hematology), Washington University in St. Louis, St. Louis, MO, United States
| | - Bowofoluwa Sharon Abimbola
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Temiloluwa Ojopagogo
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Leona Chika Okoli
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Mary Adesina
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Priscilla Ngozi Ezemelue
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
| | - Omowunmi Sowunmi
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Jane Okwuzu
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
| | - Olaoniye Habeebat Labo−Popoola
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph Ojonugwa Shaibu
- Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Greg Aigbe Ohihoin
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
| | - Emily Nzeribe
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo, Nigeria
| | - Agatha David
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
| | - Olufemi Olaleye
- Screening Section, Optimal Cancer Care Foundation Centre, Lagos, Nigeria
| | - Ighovwerha Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Xiao−ping Dong
- Center for Global Public Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Oliver Chukwujekwu Ezechi
- Centre for Reproduction and Population Health Studies, Department of Clinical Sciences, Nigeria Institute Medical Research, Lagos, Nigeria
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Challagundla N, Chrisophe-Bourdon J, Agrawal-Rajput R. Chlamydia trachomatis infection co-operatively enhances HPV E6-E7 oncogenes mediated tumorigenesis and immunosuppression. Microb Pathog 2023; 175:105929. [PMID: 36565970 DOI: 10.1016/j.micpath.2022.105929] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
Chlamydia trachomatis and human papilloma virus (HPV) are the two most common sexually transmitted infections among women. HPV infection can increase the risk of cervical cancer and infertility while C. trachomatis induces pelvic inflammatory disease. Here, we elucidate the molecular conundrum of the co-infection of HPV and C. trachomatis infection and their outcome with respect to cervical cancer. HPV infection was mimicked by overexpression of HPV 16 E6-E7 or using human cervical cell lines SiHa and C33a (with and without HPV 16 respectively). HPV transfected co-infection increased cell proliferation and resistance to H202 and TNFα-induced cell death compared to individual infections. These changes are brought by alteration in the cell cycle proteins (CDK2, CDK6 and Bcl2) and thus increasing the stemness of the epithelial cells as observed by increased colony forming units and CD133 expression. The co-infection also induces change in the mRNA levels of cells which are involved in mesenchymal phenotype. C. trachomatis in presence of E6-E7 overexpression caused cervical epithelial neoplasm in mice with increased Ki67 expression and decreased P53 levels. Stem cell marker, CD133 expression also increased in the cervical tissues of both infected and co-infected group of mice. The cells obtained from the cervix were able to grow continuously in ex vivo cultures. All these results indicate the co-existence of the C. trachomatis and HPV 16 might increase the risk of cervical cancer.
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Affiliation(s)
- Naveen Challagundla
- Immunology Lab, Institute of Advanced Research, Gandhinagar, Gujarat, 382426, India
| | - Jean Chrisophe-Bourdon
- Department of Surgery and Molecular Oncology, University of Dundee/Inserm U858, European Associated Laboratory, Dundee, DD1 9SY, United Kingdom
| | - Reena Agrawal-Rajput
- Immunology Lab, Institute of Advanced Research, Gandhinagar, Gujarat, 382426, India.
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Prevalence, Diversity, and Risk Factors for Cervical HPV Infection in Women Screened for Cervical Cancer in Belém, Pará, Northern Brazil. Pathogens 2022; 11:pathogens11090960. [PMID: 36145392 PMCID: PMC9506000 DOI: 10.3390/pathogens11090960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common viral sexually transmitted infection of the reproductive tract, and cervical cancer is the most common HPV-related disease. This study estimated the prevalence, diversity of HPV genotypes, and associated risk factors in women screened for cervical cancer in northern Brazil. Methods: The cross-sectional study was conducted in Belém, Pará, in the Amazon region of Brazil, and it included 162 women who were spontaneously undergoing a Pap-smear routine. Epidemiological, sexual, and health-related information was collected by interviews, and cervical samples were collected for cytological examination and HPV-DNA detection. HPV genotypes were classified as low risk (LR) and high risk (HR) by nucleotide sequencing. Results: In total, 17.3% (28/162) of the participants had HPV-DNA, and LR-HPV was the most prevalent (71.4%). Among the 13 different types of HPV detected, HPV-11 was found most frequently (12/28; 42.9%), followed by HPV-31 (3/28; 10.7%). Of the participants with cytological alterations, HPV infection was detected in only four: two were diagnosed with low-grade squamous intraepithelial lesions (15.4%), one with atypical squamous cells of undetermined significance (7.7%), and one with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (7.7%). Of the 61 women who presented a normal cytology, 13 (21.3%) had positive tests for HPV infection, 4 (8.2%) of which were positive for a high-risk genotype. Conclusion: The prevalence of HPV was high in Belém, Pará, and especially in women who had normal cytology results, which suggests the need for greater screening for HPV infection in women’s primary health care.
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