Department of Pathology, Gil Medical Center, Incheon, Korea.
J Gynecol Oncol. 2011 Sep;22(3):207-10. doi: 10.3802/jgo.2011.22.3.207. Epub 2011 Sep 28.
Here we report the first Korean case of a girl who developed noninvasive squamous cell carcinoma of the vulva at the age of 16 years. She was taking tacrolimus, an immunosuppressive agent, after living-related liver transplantation. The vulvar masses were microscopically proved as vulvar intraepithelial neoplasm II and III, even squamous cell carcinoma in situ. Human papillomavirus subtypes (69 and 73) and human papillomavirus types (66, 70, 73, and 43) were detected in the vulvar mass and the cervicovaginal smear, respectively. The outcome of liver transplantation for children has been markedly improved during the last several decades. However, the present case highlights the need to perform periodic genital examinations for the adolescents after liver transplantation. In addition to the high risk and probable high subtypes, uncommonly found human papillomavirus subtypes were extracted from her vulvar cancer. The present case is the first to show the possible relationship between previously unknown and uncommon human papillomavirus subtypes and pediatric post-transplant vulvar squamous cell carcinoma. More attention should be paid to the vulvar and cervical surveillance of pediatric transplant recipients by both medical specialists and general physicians.
在这里，我们报告了首例韩国病例，一名 16 岁女孩在接受亲属活体肝移植后，因使用免疫抑制剂他克莫司而罹患外阴非浸润性鳞状细胞癌。外阴肿块的显微镜检查结果为外阴上皮内瘤变 II 级和 III 级，甚至为原位鳞状细胞癌。外阴肿块和宫颈阴道涂片分别检测出人乳头瘤病毒亚型（69 和 73）和人乳头瘤病毒类型（66、70、73 和 43）。在过去几十年中，儿童肝移植的预后已显著改善。然而，本病例强调了青少年肝移植后需要定期进行生殖器检查。除了高危和可能的高亚型外，还从她的外阴癌中提取了罕见的人乳头瘤病毒亚型。本病例首次表明以前未知和罕见的人乳头瘤病毒亚型与儿科肝移植后外阴鳞状细胞癌之间可能存在关联。医学专家和普通医生都应该更加关注儿科移植受者的外阴和宫颈监测。
