Erman-Vlahovic Mirna, Vlahovic Jelena, Mrcela Milanka, Hrgovic Zlatko
Department of Gynecology and Obstetrics, Clinical Hospital Center Osijek, Croatia.
Universitiy Medical School Osijek, Clinical Hospital Center Osijek, Croatia.
Med Arch. 2017 Feb;71(1):72-75. doi: 10.5455/medarh.2017.71.72-75. Epub 2017 Feb 5.
Condyloma acuminatum has previously been considered to be a benign growth with no malignant potential, but a review of the literature supports the concept that condylomata acuminata may precede or be associated with invasive squamous cell carcinoma (ISCC) or warty squamous cell carcinoma (WSCC).
We present a clinical case of a 58-year old woman with large, slow-growing, exophytic tumor of external genitalia shaped like a cauliflower with the propagation to both legs and behind. We performed multiple biopsies to detect potential malignancy but malignancy was not confirmed histologically. The presence of HPV (human papilloma virus) low and high risk was discovered. Inguinal lymph nodes were enlarged both sides, but cytologic examination identified no malignant cells. The patient was initially treated by the loop electro surgical excision procedure (LEEP) and podophilin solution on the rest of the condylomas. Condyloma acuminatum was confirmed histologically. Later, we performed a wide surgical excision of the rest of the condylomas. The new changes on the previously treated region were removed using LEEP. WSCC and ISCC were confirmed histologically so were radical vulvectomy and inguinal lymphadenectomy performed. The patient was advised to remain under close follow-up.
尖锐湿疣以前被认为是一种无恶性潜能的良性生长，但文献综述支持这样一种观点，即尖锐湿疣可能先于浸润性鳞状细胞癌（ISCC）或疣状鳞状细胞癌（WSCC）出现或与之相关。
我们呈现了一名58岁女性的临床病例，其外阴部有一个巨大、生长缓慢、外生性肿瘤，形状如菜花，蔓延至双腿及臀部。我们进行了多次活检以检测潜在的恶性病变，但组织学检查未证实有恶性病变。发现存在低风险和高风险的人乳头瘤病毒（HPV）。双侧腹股沟淋巴结肿大，但细胞学检查未发现恶性细胞。患者最初接受了环形电外科切除术（LEEP），其余尖锐湿疣部位使用足叶草脂溶液治疗。组织学检查确诊为尖锐湿疣。后来，我们对其余的尖锐湿疣进行了广泛的手术切除。使用LEEP切除了先前治疗区域出现的新病变。组织学检查确诊为WSCC和ISCC，因此进行了根治性外阴切除术和腹股沟淋巴结清扫术。建议患者密切随访。
