Low-risk HPV-associated invasive carcinoma with squamous and glandular features arising in a Buschke-Löwenstein tumour.
Nuray Tezcan, Jinru Shia, Dorukhan Bahceci
✦ AI-curated · Sources linked
Case in brief
A 70-year-old woman underwent abdominoperineal resection for an anal mass associated with a perirectal abscess and rectovaginal fistula. Histology showed a circumferential papillary-verrucous lesion consistent with condyloma acuminatum/Bushke-Löwenstein tumour, with transition to invasive carcinoma extending through the anal wall. The carcinoma had intimately admixed squamous and mucinous glandular components, including areas of each morphology alone. High-risk HPV testing was negative, while in situ hybridization detected HPV types 6/11 in the condylomatous and both invasive components. The glandular component’s immunophenotype supported a non-colorectal origin.
What made this case unusual
The invasive carcinoma arising in a Buschke-Löwenstein tumour showed genuine glandular as well as squamous differentiation, despite association with low-risk HPV types 6/11 and no detectable high-risk HPV.
Diagnostic / clinical pearl
In an invasive carcinoma arising in a Buschke-Löwenstein tumour, mixed glandular and squamous morphology does not exclude low-risk HPV association; HPV 6/11 signals were present in both components in this case.