Mynbaev, O. and Balmasova, I. and Griffin, H. and Doorbar, J. and Medvediev, M. (2012) Combined condylomatosis and Buschke-Loewenstein tumor: case report & systematic review. Eurogin 2012. p. 216.
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Abstract
Objectives: An undesired manifestation of HPV is the transformation of infected cells into neoplastic cells, with the subsequent development of precancerous intraepithelial lesions and in some instances cancer. The generally benign manifestations of HPV include asymptomatic and subclinical disease as well as anogenital condyloma acuminatum, warts and verruccosis. Certain HPV manifestations are however associated with poor outcome for the patient, and these include giant and multiple condylomas such as Buschke- Löwenstein tumor (BLT), and respiratory papillomatosis and their relapses. These conditions decrease the patient’s life quality, and have the potential to progress to malignancy, and are a particular problem for practitioners. Management of these patients is complicated due to the absence of therapies that can eliminate HPV and prevent wart recurrence, or medication that can cure genital warts and condylomas. Indeed, although there are many clinical reports describing the aggressive manifestation of genital warts in immune compromised individuals, the triggering mechanisms for such atypical lesions is not yet understood. Our objective here is to present a case report of combined condylomatosis and BLT in a patient with Henoch-Schönlein purpura and simultaneously infected with six HPV genotypes (6, 11, 18, 31, 43 & 56), and to systematicly review the literature in order to provide a better insight into these conditions. Methods: Clinical and laboratory parameters as well as a video of surgery of female patient (30 ys) with combined condylomatosis and BLT (the informed consent was obtained). Clinical and research literature over the last 15 years focusing on the immunological aspects of papillomavirus interaction with the innate and adaptive immune systems, and interference with the cellular and humoral host responses. Particular attention is given to the nature of papillomavirus clearance and persistence. Conclusions: Atypical manifestation of HPV was in our case related to systemic disease involving an autoimmune host response and long-term glucocorticoid treatment. Our review confirms that such atypical manifestations and the long-term persistence of HPV are often linked to disturbances in the hosts immune system. More specifically these comprise changes in the content of lymphocyte subsets (helper, cytotoxic and regulatory T-cells), NK cells and macrophages at HPV infected sites and in the blood, as well as changes in lymphocyte function related to the expression of INF-<& ®, IL-2; IL-4, IL-10, TGF®‚ and other cytokines.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HPV, condyloma, vulvar lesions |
| Subjects: | Gynecology |
| Divisions: | Departments > Department of Obstetrics and Gynecology |
| Depositing User: | Анастасия Жигар |
| Date Deposited: | 14 Sep 2015 07:39 |
| Last Modified: | 14 Sep 2015 07:39 |
| URI: | http://repo.dma.dp.ua/id/eprint/464 |
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