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Non HPV-related cervical squamous cell carcinoma with unusual histologic characteristics mimicking a giant immature condyloma: a case report
  1. Ko-Hsin Tsai1,
  2. Kuan-Ting Kuo2,
  3. Chi-Hau Chen1,
  4. Ho-Hsiung Lin1
  1. 1Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
  2. 2Department of Pathology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Professor Ho-Hsiung Lin, Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, No. 8 Chung-Shan South Road, Taipei 100, Taiwan; hhlin{at}ntuh.gov.tw

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Introduction

Cervical cancer is one of the most common female cancers, ranking third behind breast cancer and colorectal cancer globally. Attributing to the success of Papanicolaou (Pap) screening and the human papillomavirus (HPV) test, the incidence and mortality rates have significantly reduced in recent years.

The immature condyloma, also named papillary immature metaplasia or papillary squamous intraepithelial lesion, is a rare form of low-grade squamous intraepithelial lesions (LSIL) of the uterine cervix.1 This lesion is usually associated with HPV types 6 and 11. Although high-grade squamous intraepithelial lesions (HSIL) have been reported with concurrent immature condyloma, no associated cervical cancer has been reported, especially with a HPV-negative malignancy.2 Here, we report the rare case of a HPV-negative cervical carcinoma imitating a giant immature condyloma.

Case

A 62-year-old woman with four partitions noted vaginal spotting for more than 1 year before visiting our department of obstetrics and gynecology in May 2009. Pap smear had never been done before. Increased amount of bleeding was noted over the past 1 month, so she came to our department for help. During the specular examination, a huge cervical papillary lesion about 3.5×3 cm in size almost completely occupying the view of the cervical os with easy oozing was found. Colposcopy-directed biopsies were done twice. The diagnosis of papillary LSIL was confirmed twice by pathologists. After considering her unusual clinical presentation and consulting with pathologists, we performed total abdominal hysterectomy and bilateral salpingo-oophorectomy under …

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