Yiu Z Z N, Ali F R, Wilson M S, Mowatt D, Lyon C C
The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
Christie Hospital, Manchester, UK.
Int J Surg Case Rep. 2014;5(12):1014-7. doi: 10.1016/j.ijscr.2014.10.063. Epub 2014 Oct 30.
Giant condylomata acuminata (GCA) is a rare, locally invasive tumour that may undergo malignant transformation. It was first described a HPV-induced penile tumour which clinically resembled both a squamous cell carcinoma and condyloma acuminatum, often arising from a pre-existing warty lesion. We describe a case of peri-stomal GCA transformation into invasive squamous cell carcinoma (SCC), which is, to our knowledge, the first report of this in the literature.
A 74 year old gentleman developed an acuminate, papillomatous peristomal eruption around a fifty year old ileostomy, with biopsies of the eruption showing reactive changes. Two years later, he developed ulcerating plaques affecting the previously papillomatous areas and an erythematous nodular lesion involving the superior part of the ileostomy and adjacent skin. Histological examination of the ileostomy lesion showed focal small islands of atypical squamous epithelium, and moderately differentiated invasive squamous cell carcinoma was shown in the excised tissue subsequently. Human papillomavirus (HPV type 16), p16 and p53 tumour suppressors were positive in the peri-stomal skin sample.
Recurring, changing papillomatous lesions in the peristomal area should be reviewed with a high index of suspicion in relation to GCA tumours as they can progress to invasive squamous cell carcinomas.
巨大尖锐湿疣（GCA）是一种罕见的局部侵袭性肿瘤，可能会发生恶性转化。它最初被描述为一种人乳头瘤病毒诱导的阴茎肿瘤，临床上既类似鳞状细胞癌又类似尖锐湿疣，通常起源于先前存在的疣状病变。我们报告一例造口周围巨大尖锐湿疣转化为浸润性鳞状细胞癌（SCC）的病例，据我们所知，这是文献中首例此类报告。
一名74岁男性在其已有50年的回肠造口周围出现尖锐的乳头状造口周围皮疹，对该皮疹进行活检显示为反应性改变。两年后，他出现溃疡斑块，累及先前的乳头状区域，以及一个累及回肠造口上部和邻近皮肤的红斑性结节病变。回肠造口病变的组织学检查显示有局灶性非典型鳞状上皮小岛，随后在切除组织中显示为中分化浸润性鳞状细胞癌。人乳头瘤病毒（16型）、p16和p53肿瘤抑制因子在造口周围皮肤样本中呈阳性。
造口周围区域反复出现、形态改变的乳头状病变应高度怀疑为巨大尖锐湿疣肿瘤，因为它们可能进展为浸润性鳞状细胞癌。
