Warty carcinoma of uterine cervix - review of the literature and case report

Abstract

Introduction. The Histological Classification of Epithelial Tumors of the Uterine Cervix of the World Health Organization includes inter alia warty carcinoma as a variant of squamous cell carcinoma. Until now several case reports and studies have shown that this particular cancer is associated with human papillomavirus/ HPV infection. Case presentation. A 58-year-old woman presented with a vegetant cervical tumour. Biopsy samples were collected from the tumour, and the histological exam successively confirmed the warty cell carcinoma. Additional tests revealed the presence of single human papillomavirus/ type-45. An immunohistochemistry exam was performed in order to confirm the diagnosis, and also to highlight the relationship between the potential causal factors and the morphological appearance. This allowed the confirmation of the diagnosis, and added new elements able to define the characteristics of this form of cancer. The treatment included radiotherapy and radical hysterectomy with anexectomy, and pelvic lymphadenectomy. The evolution was favorable, with no signs of local recurrence or metastasis in the past five years. Conclusions. Warty carcinoma, relatively similar to condyloma acuminatum or verrucous carcinomas, has specific immune-histochemical features that differentiate it from other variants of squamous cell carcinoma. The HPV genotype 45 can be considered a causative factor in the pathogenesis of cervical warty carcinoma. Even so, warty carcinoma appears not to be caused by a specific HPV subtype (or a combination of several specific genotypes), being rather a multifactorial affection.

Keywords

• cervical cancer
• human papillomavirus
• warty carcinoma