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Dacryoendoscopy-guided transcanalicular intralesional interferon alpha 2b for canalicular squamous papillomas. Int Ophthalmol 2017; 38:1343-1346. [PMID: 28540494 DOI: 10.1007/s10792-017-0572-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/20/2017] [Indexed: 10/19/2022]
Abstract
Canalicular papillomatosis is a rare disorder characterized by a mass lesion arising from the epithelium as a stalk from one of the canalicular walls. Traditionally, they have been treated with an open canaliculotomy and excision biopsy with or without additional cryotherapy. A patient with upper canalicular squamous papillomas treated with dacryoendoscopy-guided transcanalicular intralesional and topical interferon alpha 2b is presented, and the ineffectiveness of interferons in this case is discussed.
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Abstract
Tumors of the Ocular Surface clinically manifest with a very wide spectrum and include several forms of epithelial, stromal, caruncular, and secondary tumors. As a group, these tumors are seen commonly in the clinical practice of a comprehensive ophthalmologist, cornea specialist, and an ocular oncologist. This review is aimed to discuss the common tumors of the ocular surface and emphasize on their clinical diagnosis and appropriate management.
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Affiliation(s)
- Santosh G Honavar
- Department of Ophthalmic Plastic Surgery and Ocular Oncology, Centre for Sight, Hyderabad, India
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3
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Squamous Neoplasms of the Conjunctiva. Cornea 2011. [DOI: 10.1016/b978-0-323-06387-6.00046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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4
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Abstract
Not only does genital "high risk HPV 16" play a significant role in cervical carcinomas, it is also the most commonly found mucosal virus in groups of well-defined but atypical infections on the skin. In this group are included 1. Bowen disease, 2. squamous cell carcinomas on fingertips and nail units, 3. squamous cell carcinomas of eyelids and conjunctiva, 4. papillomas and squamous cell carcinoma of the external auditory canal. Bowen disease is a carcinoma in situ with a good prognosis and usually does not turn into a Bowen carcinoma. There is a close relation to genital high risk HPV, but integration of HPV 16 DNA into the cellular genome is rarely found in Bowen disease, and seems to appear only when there is a development into Bowen carcinoma. It is unclear how mucosal HPV infect the skin. Most authors assume that genito-digital inoculation occurs. However, in many cases of cutaneous Bowen disease there is no evidence of genital change and in most reported cases there is no immunosuppression. Similarly, in the case of rare carcinomas of fingers and nail units HPV 16 and HPV 16 - related types seem implicated. There is an almost universal assumption that infection here occurs via genital-digital contact. Immunosuppression, for example due to organ transplant or HIV infection, accelerates the emergence and spread of carcinomas. The mechanism of these types of carcinogenesis appears to be similar to that of the formation of cervical carcinomas. Although the central role in triggering carcinogenesis is played by persistent HPV infection, as is the case in cervical carcinoma, further factors must play a part, for example the condition of the immune system. Loss of immunological control can lead to a lasting proliferation of HPV infected cells. Additional factors such as UV light and toxic substances may enhance carcinogenesis, by lowering local tissue immunity and thus reducing intra-cellular control.
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Manderwad GP, Kannabiran C, Honavar SG, Vemuganti GK. Lack of association of high-risk human papillomavirus in ocular surface squamous neoplasia in India. Arch Pathol Lab Med 2009; 133:1246-50. [PMID: 19653719 DOI: 10.5858/133.8.1246] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2009] [Indexed: 11/06/2022]
Abstract
CONTEXT Ocular surface squamous neoplasia (OSSN) represents a spectrum of ocular surface tumors ranging from intraepithelial to invasive. The genesis of OSSN is multifactorial, possibly including human papillomavirus (HPV) infection, the role of which is controversial. OBJECTIVE To evaluate the role of high-risk HPV16 and HPV18 in OSSN. DESIGN Retrospective and prospective noncomparative case series. In this study, histologically proven cases of OSSN were evaluated in formalin-fixed, paraffin-embedded sections (n = 50) and fresh tissues (n = 7) for the presence of HPV by polymerase chain reaction using MY09/MY11 consensus primers, HPV16 and HPV18 type-specific primers, and in situ hybridization-catalyzed reporter deposition (ISH-CARD). Cervical tumors (n = 19) along with SiHa and HeLa cell lines served as positive controls for HPV analysis. RESULTS The study included 48 patients with OSSN who accounted for 57 specimens, with a median patient age of 28.5 years (range, 1.5-70 years). These specimens included 36 squamous cell carcinomas and 21 conjunctival intraepithelial neoplasias. All of the cases were found to be negative for high-risk HPV using polymerase chain reaction and ISH-CARD assay, whereas the SiHa and HeLa cell lines were appropriately positive. Of the cervical tumors that served as positive controls, 18 were positive for HPV16, and 1 was positive for HPV18. CONCLUSIONS Sensitive, type-specific polymerase chain reaction for detection of HPV16 and HPV18, polymerase chain reaction assay for consensus HPV sequences, and ISH-CARD did not show the presence of high-risk HPV in OSSN. Thus, HPV appears to play no significant role in the etiology of OSSN in India.
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Affiliation(s)
- Guru Prasad Manderwad
- Ophthalmic Pathology Services, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India
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Verma V, Shen D, Sieving PC, Chan CC. The role of infectious agents in the etiology of ocular adnexal neoplasia. Surv Ophthalmol 2008; 53:312-31. [PMID: 18572051 DOI: 10.1016/j.survophthal.2008.04.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Given the fact that infectious agents contribute to around 18% of human cancers worldwide, it would seem prudent to explore their role in neoplasms of the ocular adnexa: primary malignancies of the conjunctiva, lacrimal glands, eyelids, and orbit. By elucidating the mechanisms by which infectious agents contribute to oncogenesis, the management, treatment, and prevention of these neoplasms may one day parallel what is already in place for cancers such as cervical cancer, hepatocellular carcinoma, gastric mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma. Antibiotic treatment and vaccines against infectious agents may herald a future with a curtailed role for traditional therapies of surgery, radiation, and chemotherapy. Unlike other malignancies for which large epidemiological studies are available, analyzing ocular adnexal neoplasms is challenging as they are relatively rare. Additionally, putative infectious agents seemingly display an immense geographic variation that has led to much debate regarding the relative importance of one organism versus another. This review discusses the pathogenetic role of several microorganisms in different ocular adnexal malignancies, including human papilloma virus in conjunctival papilloma and squamous cell carcinoma, human immunodeficiency virus in conjunctival squamous carcinoma, Kaposi sarcoma-associated herpes virus or human herpes simplex virus-8 (KSHV/HHV-8) in conjunctival Kaposi sarcoma, Helicobacter pylori (H. pylori,), Chlamydia, and hepatitis C virus in ocular adnexal mucosa-associated lymphoid tissue lymphomas. Unlike cervical cancer where a single infectious agent, human papilloma virus, is found in greater than 99% of lesions, multiple organisms may play a role in the etiology of certain ocular adnexal neoplasms by acting through similar mechanisms of oncogenesis, including chronic antigenic stimulation and the action of infectious oncogenes. However, similar to other human malignancies, ultimately the role of infectious agents in ocular adnexal neoplasms is most likely as a cofactor to genetic and environmental risk factors.
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MESH Headings
- Alphapapillomavirus/isolation & purification
- Alphapapillomavirus/physiology
- Carcinoma, Squamous Cell/virology
- Chlamydophila psittaci/isolation & purification
- Chlamydophila psittaci/physiology
- Conjunctival Neoplasms/microbiology
- Conjunctival Neoplasms/virology
- Eye Infections, Bacterial/microbiology
- Eye Infections, Bacterial/pathology
- Eye Infections, Viral/pathology
- Eye Infections, Viral/virology
- Eye Neoplasms/microbiology
- Eye Neoplasms/virology
- Eyelid Neoplasms/microbiology
- Eyelid Neoplasms/virology
- HIV-1/isolation & purification
- HIV-1/physiology
- Helicobacter pylori/isolation & purification
- Helicobacter pylori/physiology
- Hepacivirus/isolation & purification
- Hepacivirus/physiology
- Herpesvirus 8, Human/isolation & purification
- Herpesvirus 8, Human/physiology
- Humans
- Lacrimal Apparatus Diseases/microbiology
- Lacrimal Apparatus Diseases/virology
- Lymphoma, B-Cell, Marginal Zone/virology
- Orbital Neoplasms/microbiology
- Orbital Neoplasms/virology
- Sarcoma, Kaposi/virology
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Affiliation(s)
- Varun Verma
- Immunopathology Section, Laboratory of Immunology, National Eye Institute, Bethesda, Maryland 20892-1857, USA
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Minchiotti S, Masucci L, Serapiao Dos Santos M, Perrella E, Graffeo R, Lambiase A, Bonini S. Conjunctival papilloma and human papillomavirus: identification of HPV types by PCR. Eur J Ophthalmol 2006; 16:473-7. [PMID: 16761254 DOI: 10.1177/112067210601600320] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To report the identification of human papillomavirus types in four cases of conjunctival papillomas and to review the literature regarding human conjunctival papillomavirus (HPV). METHODS Specimens from conjunctival papillomas of four patients were analyzed for the presence of HPV by polymerase chain reaction and subsequent filter hybridization. HPV types 6, 11, 16, 18, 31, and 33 were investigated. Histologic sections were analyzed for the presence of koilocytosis. RESULTS Histologic examination confirmed HPV infection in all cases. HPV type 11 was detected in all specimens. CONCLUSIONS HPV is frequently implicated in the pathogenesis of proliferative squamous lesions. HPV type 11 was the most frequently found in benign conjunctival lesion in this study.
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Affiliation(s)
- S Minchiotti
- Department of Ophthalmology, University of Roma 'Campus Bio-Medico', Roma, Italy
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Abstract
Even though ocular surface squamous neoplasia (OSSN) has been recognized for well over a century, the past decade has witnessed advances that have helped rewrite many of the paradigms for the diagnosis and management of these lesions. OSSN occurs predominantly in the elderly for whom they are the third most common oculoorbital tumors after melanoma and lymphoma. In addition to advanced age and male sex, other major risk factors linked to its pathogenesis are ultraviolet light, cigarette smoking, and the human papilloma virus. Although the latter has been linked to OSSN for nearly 4 decades, its identification and role in the pathogenesis of these tumors has been elucidated recently and is addressed in detail in this review. Newer techniques of impression cytology represent a noninvasive and reliable method of diagnosing OSSN and monitoring treated cases. The efficacy of chemotherapeutic agents such as mitomycin C and 5-fluorouracil have been proven in the recent past, making them a clear alternative to the time-tested treatment of surgical excision and cryotherapy. Early reports on the efficacy of topical Iterferon alpha 2b indicate significant promise in providing another alternative for the treatment of some of these neoplasms. These advances thus represent a minimally invasive and highly successful approach to the diagnosis and treatment of OSSN.
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Affiliation(s)
- Surendra Basti
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60025, USA.
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9
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Abstract
Most ocular and orbital tumors of childhood are distinct from tumors that occur in adults. Many are congenital with early presentations. Most pediatric orbital tumors are benign; developmental cysts comprise half of orbital cases, with capillary hemangioma being the second most common orbital tumor. The most common orbital malignancy is rhabdomyosarcoma. The most common intraocular malignant lesion is retinoblastoma. Choroidal melanoma, which is common in adults, is extremely rare in children. The orbit is the most common location for metastases in children, whereas the choroid is the predominant site in adults. Pediatricians play a vital role in diagnosis of pediatric ocular tumors. They are the first to recognize ocular problems that may not be apparent to parents. It is therefore important to recognize the signs and symptoms of ocular tumors of childhood so that prompt ophthalmologic evaluation and treatment may be undertaken. Whereas the malignant tumors may be life-threatening, both malignant and benign tumors may be vision-threatening.
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Affiliation(s)
- Bienvenido V Castillo
- Division of Pediatric Ophthalmology and Strabismus, Loyola University Medical Center, 2160 First Avenue, Maywood, IL 60152, USA
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Whittaker KW, Trivedi D, Bridger J, Sandramouli S. Ocular surface squamous neoplasia: report of an unusual case and review of the literature. Orbit 2002; 21:209-15. [PMID: 12187415 DOI: 10.1076/orbi.21.3.209.7173] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe a case of leukoplakia and underlying intraepithelial squamous cell neoplasia of the palpebral conjunctiva presenting in a patient wearing an ocular prosthesis. METHODS The clinical presentation, histopathological findings and surgical outcome are described in a 62-year-old man in whom leukoplakic lesions of the palpebral conjunctiva in a socket fitted with an ocular prosthesis were noted in addition to squamous cell carcinoma of the lower lid skin. RESULTS Histopathological examination revealed islands of squamous cell carcinoma in the skin lesion and squamous cell carcinoma-in-situ in the leukoplakic conjunctival specimen. Successful tumour excision and lid reconstruction were performed. CONCLUSION This report highlights the successful treatment of long-standing conjunctival squamous cell carcinoma-in-situ associated with an ocular prosthesis and a general tendency to pre-neoplastic lesions of the skin. Regular examination of the sockets of patients wearing long-standing ocular prostheses is recommended.
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Affiliation(s)
- Karl W Whittaker
- Wolverhampton and Midland Counties Eye Infirmary, Wolverhampton, England, UK.
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11
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Scott IU, Karp CL, Nuovo GJ. Human papillomavirus 16 and 18 expression in conjunctival intraepithelial neoplasia. Ophthalmology 2002; 109:542-7. [PMID: 11874759 DOI: 10.1016/s0161-6420(01)00991-5] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate conjunctival intraepithelial neoplasia (CIN) and normal conjunctiva for the presence of human papillomavirus (HPV) DNA and for expression (as detected by the presence of mRNA) of the HPV E6 region. DESIGN Prospective, case-controlled study. PARTICIPANTS Ten consecutive patients who underwent CIN excision by one surgeon (CLK) and five age-matched control subjects who underwent retinal detachment repair at the Bascom Palmer Eye Institute. METHODS A reverse transcriptase in situ polymerase chain reaction (PCR) technique was used to search for the presence of HPV mRNA in CIN specimens from 10 consecutive patients who underwent CIN excision by one surgeon (CLK) at Bascom Palmer Eye Institute, as well as in clinically uninvolved conjunctival specimens from the same eyes of these patients. In addition, conjunctival specimens from five control subjects (age-matched to five of the cases), who had no clinically identifiable conjunctival disease and who underwent retinal detachment repair at the Bascom Palmer Eye Institute, were analyzed in a similar manner. The clinical diagnoses of CIN and normal conjunctiva were confirmed histopathologically in all cases by an ocular pathologist, who was masked as to the patients' clinical diagnoses, and the PCR testing was performed by an investigator (GJN) who was masked as to the clinical diagnoses. RESULTS HPV 16 DNA and mRNA were present in five CIN specimens, and HPV 18 DNA and mRNA were present in the other five CIN specimens; neither HPV 16 or 18 DNA nor mRNA were detected in any of the control specimens or in any of the clinically uninvolved conjunctival specimens (P < 0.001). In each of the CIN specimens, 20% to 40% of the dysplastic cells expressed the HPV E6 region. CONCLUSIONS HPV 16 or 18 DNA and mRNA corresponding to the E6 region were detected in all CIN specimens examined. HPV 16 or 18 DNA or mRNA was not present in any of the control or uninvolved conjunctival specimens. The consistency of the current findings with those reported for human cervical malignant lesions, and the fact that the protein encoded by the E6 region of HPV 16 and 18 has been shown to form a complex with the protein encoded by the host tumor suppressor gene p53, provide strong evidence for an etiologic role of HPV in the development of CIN.
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Affiliation(s)
- Ingrid U Scott
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL 33101, USA
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12
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Eng HL, Lin TM, Chen SY, Wu SM, Chen WJ. Failure to detect human papillomavirus DNA in malignant epithelial neoplasms of conjunctiva by polymerase chain reaction. Am J Clin Pathol 2002; 117:429-36. [PMID: 11888082 DOI: 10.1309/rvup-qmu3-5x6w-3cq1] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To elucidate the putative role of human papillomavirus (HPV) infection in the etiology of conjunctival tumors, 44 formalin-fixed, paraffin-embedded specimens of conjunctival tumors (24 patients with papillomas and 20 patients with dysplastic and/or malignant tumors) were screened for HPV infection using 4 different polymerase chain reactions (PCRs). Of the 24 samples of papilloma, 14 (58%) displayed positive results by applying nested PCR using primer sets of HPV consensus L1 region. HPV type 6 or 11 was detected in 9 cases of papilloma by type-specific primer sets, but none of them were positive for HPV type 16 or 18. However, by using the highly sensitive PCR technique, we failed to demonstrate the HPV DNA of HPV types 6, 11, 16, and 18 in any of the 20 malignant epithelial tumors of conjunctiva. We conclude that HPV-6 or HPV-11 is present in a substantial percentage of conjunctival papillomas, which is in accordance with findings of previously reported studies. In contrast, malignant conjunctival carcinomas are not associated with HPV infection; other pathogenic mechanisms, such as UV light, probably are more important in the cause of these malignant lesions.
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Affiliation(s)
- Hock-Liew Eng
- Department of Pathology, Kaohsiung Medical Center, Chang Gung University and Memorial Hospital, Taiwan, Republic of China
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13
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Sjö NC, Heegaard S, Prause JU, von Buchwald C, Lindeberg H. Human papillomavirus in conjunctival papilloma. Br J Ophthalmol 2001; 85:785-7. [PMID: 11423448 PMCID: PMC1724043 DOI: 10.1136/bjo.85.7.785] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM To examine conjunctival papillomas for the presence of human papillomavirus (HPV) and koilocytosis. METHODS Archival paraffin embedded tissue from 55 conjunctival papillomas was analysed for the presence of HPV by polymerase chain reaction and subsequent filter hybridisation. Histological sections of the 55 papillomas were evaluated for the presence of koilocytosis. RESULTS HPV was present in 48 of 52 (92%) beta globin positive papillomas. HPV type 6/11 were found in 40 of 47 investigated papillomas and a double infection with HPV 6/11 and 16 was identified in a single papilloma. In six papillomas the HPV type could not be identified. Koilocytosis was present in 22 of 55 papillomas (40%). CONCLUSION There is a strong association between HPV and conjunctival papillomas. HPV type 6/11 is the most common HPV type in conjunctival papilloma. The sensitivity of koilocytosis as an indicator of HPV in conjunctival papilloma is low.
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Affiliation(s)
- N C Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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14
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Tabrizi SN, McCurrach FE, Drewe RH, Borg AJ, Garland SM, Taylor HR. Human papillomavirus in corneal and conjunctival carcinoma. AUSTRALIAN AND NEW ZEALAND JOURNAL OF OPHTHALMOLOGY 1997; 25:211-5. [PMID: 9296295 DOI: 10.1111/j.1442-9071.1997.tb01394.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the role of human papillomavirus (HPV) types, 6, 11, 16 and 18 in corneal and conjunctival carcinoma, we examined 88 dysplastic corneal and conjunctival specimens and 66 controls that had been formalin-fixed and paraffin-embedded. METHODS Sections were graded for histological abnormality by light microscopy and the presence of HPV DNA was determined by polymerase chain reaction using LI consensus primers. RESULTS Human papillomavirus DNA was detected in 34 (39%) dysplasias and in five (7.5%) controls. Of dysplasias that were HPV-positive, 20 (59%) contained either types 16 or 18, 13 (38%) contained only types 6/11, while combinations of HPV types were present in 11 (32%). A histological correlation was found with HPV positivity (all genotypes) and unusually large ('epithelioid') dysplastic cells. CONCLUSION The present study demonstrates a lower incidence of HPV in corneal and conjunctival carcinoma than previously reported, but shows an unexpectedly high incidence of HPV 6/11 in conjunctival carcinomas.
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Affiliation(s)
- S N Tabrizi
- Department of Microbiology, Royal Women's Hospital, Carlton, Victoria, Australia.
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15
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Abstract
Squamous cell carcinoma of the conjunctiva is a rare tumour with a multifactorial aetiology. There is strong epidemiological evidence that exposure to solar ultraviolet radiation is an important cause and that HIV infection predisposes to its development. The role of other factors, such as human papillomavirus infection, is unclear.
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Affiliation(s)
- R Newton
- Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford, UK
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Budayr M, Ankney RN, Moore RA. Condyloma acuminata in infants and children. A survey of colon and rectal surgeons. Dis Colon Rectum 1996; 39:1112-5. [PMID: 8831525 DOI: 10.1007/bf02081410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Condyloma acuminata are anogenital warts caused by a human papillomavirus. Human papillomavirus is a tissue-specific, site-specific, double-stranded DNA virus, which is capable of inducing high-grade genital intraepithelial neoplasia and malignancy. The incidence of anogenital warts in the pediatric age group is rising, and sexual abuse has been implicated as a potential cause. METHODS Accumulated data from separate questionnaires sent to practicing colorectal surgeons who are members of The American Society of Colon and Rectal Surgeons and fellows in colon and rectal training programs have been analyzed. RESULTS Thirty percent of those polled responded to our survey. Of the respondents, 93 percent see less than two pediatric cases per year. Seventy-two percent stated that tissue specimens would be sent routinely for histopathologic identification. Although 73 percent of surgeons consider anogenital warts a potentially sexually transmitted disease, only 26 percent reported screening for other sexually transmitted diseases. A diagnostic and therapeutic protocol is followed by 19 percent of respondents. Patient follow-up varied from six months (43 percent) to lifelong examinations (3 percent). Sixty-four percent of respondents agreed that a diagnostic and therapeutic protocol based on current knowledge would be beneficial. CONCLUSION We conclude that colon and rectal surgeons have a low exposure to anogenital warts in infants and children. Furthermore, we believe that a diagnostic and therapeutic protocol based on the current literature would be helpful.
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Affiliation(s)
- M Budayr
- Department of Surgery, Temple University/Conemaugh's Memorial Medical Center, Johnstown, Pennsylvania, USA
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17
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Saegusa M, Takano Y, Hashimura M, Okayasu I, Shiga J. HPV type 16 in conjunctival and junctional papilloma, dysplasia, and squamous cell carcinoma. J Clin Pathol 1995; 48:1106-10. [PMID: 8567996 PMCID: PMC503036 DOI: 10.1136/jcp.48.12.1106] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AIMS To clarify the role of human papillomavirus (HPV) infection in the development of papilloma, dysplasia, squamous cell carcinoma, and basal cell epithelioma arising from the eyelids, including the tunica conjunctiva palpebrum (conjunctiva), its junction to epidemis of eyelid skin (junction), and eyelid skin. METHODS Sixteen cases of papilloma, four of dysplasia, four of squamous cell carcinoma, and 12 of basal cell epithelioma were examined using formalin fixed and paraffin embedded samples. Detection of HPV-DNA was performed by PCR-RFLP and in situ hybridisation (ISH) methods. RESULTS HPV-16 was detected in 12/16 papillomas (75%), 2/4 dysplasias (50%), and 1/4 squamous cell carcinomas (25%) but in none of the basal cell epitheliomas. No other HPV subtypes were found. ISH assay showed positive signals in only two cases of dysplasia and squamous cell carcinoma. The mean age of HPV-16 positive dysplasia and squamous cell carcinoma cases (81.7 years) was significantly higher than that of HPV-16 positive papilloma cases (p < 0.01). CONCLUSIONS Based on the presence of HPV-16 in both benign and malignant lesions and the age distribution, it seems likely that HPV-16 alone may be incapable of causing development of conjunctival and junctional dysplasia and squamous cell carcinoma, and that any correlation between the papilloma-squamous cell carcinoma sequence and HPV infection may be due to rare events.
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Affiliation(s)
- M Saegusa
- Department of Pathology, Kitasato University School of Medicine, Kanagawa, Japan
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18
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Ross JD, Scott GR, Busuttil A. Condylomata acuminata in pre-pubertal children. MEDICINE, SCIENCE, AND THE LAW 1993; 33:78-82. [PMID: 8429775 DOI: 10.1177/002580249303300116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The medico-legal significance of anogenital warts as a marker of sexual abuse in children is unclear. This review article presents three case reports and discusses the possible modes of transmission of papilloma virus in children. Although genital warts can indicate sexual abuse, non-sexual transmission may also occur.
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Affiliation(s)
- J D Ross
- Dept of Genitourinary Medicine, Edinburgh Royal Infirmary
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19
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Tuppurainen K, Raninen A, Kosunen O, Kankkunen JP, Kellokoski J, Syrjänen S, Mäntyjärvi M, Syrjänen K. Squamous cell carcinoma of the conjunctiva. Failure to demonstrate HPV DNA by in situ hybridization and polymerase chain reaction. Acta Ophthalmol 1992; 70:248-54. [PMID: 1319099 DOI: 10.1111/j.1755-3768.1992.tb04132.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Squamous cell carcinoma of the conjunctiva is a distinct rarity, often arising at the corneoscleral limbus and initially resembling pterygium or chronic keratoconjunctivitis. In this paper we report 4 patients with conjunctival squamous cell carcinoma/carcinoma in situ, which comprise all the cases found in the files of Kuopio University Hospital during 1959-1991. The clinical appearance, diagnosis and treatment of the lesions are described. All biopsies were studied for the presence of Human papillomavirus (HPV) DNA (recently demonstrated in conjunctival squamous cell papillomas, precancer lesions and carcinomas) by using in situ DNA hybridization (ISH) and polymerase chain reaction (PCR). Both techniques failed to demonstrate the DNA of any of the following HPV types: HPV 6, 11, 16 and 18 in any of the lesions. The results are discussed in the light of the recently proposed HPV etiology of these lesions.
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Affiliation(s)
- K Tuppurainen
- Department of Ophthalmology, University of Kuopio, Finland
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20
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Abstract
Human papillomaviruses have long been identified as the cause of common warts and condylomata acuminata. Evidence is now accumulating that human papillomaviruses may be involved in not only benign, but also in malignant neoplasms. They might also be significant in the malignant transformation of cutaneous neoplasms. This review examines the oncogenic potential of human papillomaviruses when they are found in carcinomas in various anatomic areas, including the skin.
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Affiliation(s)
- M B Quan
- University of California, Los Angeles Division of Dermatology 90024
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21
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McDonnell JM, Wagner D, Ng ST, Bernstein G, Sun YY. Human papillomavirus type 16 DNA in ocular and cervical swabs of women with genital tract condylomata. Am J Ophthalmol 1991; 112:61-6. [PMID: 1652895 DOI: 10.1016/s0002-9394(14)76214-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Human papillomavirus type 16 is associated with dysplasias and carcinomas of the conjunctiva and of the uterine cervix. To explore the relationship between cervical and ocular human papillomavirus infection, we examined DNA from bilateral limbal swabs and cervical swabs from 17 women (age range, 17 to 46 years; median, 31.7 years) with biopsy-proven human papillomavirus-related cervical dysplasia who had a normal ocular surface. Using polymerase chain reaction, we identified human papillomavirus 16 DNA in one or both eyes of 13 (76.5%) patients, six (46.2%) of whom had demonstrable human papillomavirus 16 DNA in cervical swabs as well. It thus appears that human papillomavirus 16 is present in the conjunctivae of some patients with human papillomavirus-related genital warts who have no ocular manifestations of infection. Although autoinoculation of conjunctiva may be the source of some ocular human papillomavirus, data suggest that other modes of transmission to the eye also exist. Additional study of the epidemiologic characteristics of ocular human papillomavirus, a widely prevalent virus known to be associated with dysplasias/atypias and cancer, is warranted.
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Affiliation(s)
- L F Eichenfield
- Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia
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23
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Odrich MG, Jakobiec FA, Lancaster WD, Kenyon KR, Kelly LD, Kornmehl EW, Steinert RF, Grove AS, Shore JW, Gregoire L. A spectrum of bilateral squamous conjunctival tumors associated with human papillomavirus type 16. Ophthalmology 1991; 98:628-35. [PMID: 1648188 DOI: 10.1016/s0161-6420(91)32218-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Three patients with bilateral tumors presenting as multiple keratinizing and verrucous lesions of the bulbar and tarsal conjunctiva were determined by DNA amplification and hybridization studies to harbor human papillomavirus type 16 (HPV-16). Results of biopsy in two patients showed infiltrating squamous cell carcinoma in one eye and dysplasia or carcinoma in situ in the fellow eye. In the third patient, focal, inflamed, hypertrophic, papillary lesions with pseudoglandular invaginations of the surface epithelium were found in the tarsal conjunctivae of both eyes. These are the first documented cases of bilateral conjunctival tumors associated with human papillomavirus.
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Affiliation(s)
- M G Odrich
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston
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24
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Abstract
We treated two patients who had recurrent conjunctival papillomas that invaded the nasolacrimal sac and caused complete canalicular and nasolacrimal duct obstruction. The ophthalmologist should be aware of the possibility of a conjunctival papilloma invading the lacrimal sac when treating patients with conjunctival papillomas. Excision should be complete, and adjunctive therapy such as cryotherapy should be considered to reduce the chance of tumor recurrence.
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Affiliation(s)
- M E Migliori
- Department of Ophthalmology, Brown University Program in Medicine, Providence, Rhode Island
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25
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Mäntyjärvi M, Syrjänen S, Kaipiainen S, Mäntyjärvi R, Kahlos T, Syrjänen K. Detection of human papillomavirus type 11 DNA in a conjunctival squamous cell papilloma by in situ hybridization with biotinylated probes. Acta Ophthalmol 1989; 67:425-9. [PMID: 2801046 DOI: 10.1111/j.1755-3768.1989.tb01627.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A 44-year-old man presented with an exophytic papillomatous growth in the tarsal conjunctiva of his right eye. The tumour was excised and subjected to histological examination. On light microscopy, a squamous cell papilloma without signs of dysplasia was disclosed, because the entire tissue block was cut into sections, the performance of a conventional in situ hybridization for detection of human papillomavirus (HPV) DNA was not possible. An alternative approach was used to demonstrate the presence of HPV 11 DNA in the papilloma. The cover slip was removed. The individual van Gieson-stained sections on the (routine, uncoated) slides were cut apart by glass knife, and mounted (still attached on the original slide) separately on new microscopy slides. These slides were subjected to in situ DNA hybridization with biotin-labelled DNA probes of HPV 6, 11, 16, and 18, under conditions of high stringency (Tm-17 degrees C). Special caution was taken to prevent the detachment of sections. The papilloma displayed positive hybridization with the HPV-II probe, the intense signals being localized on the nuclei of koilocytotic cells. Infection with HPV-6 (or the closely related HPV-11) appears to be responsible for the majority of the conjunctival papillomas of children and young adults reported so far. The presence of genital tract HPV types 6/11 in these lesions suggests that some of the infections might have been acquired during the passage through an infected birth canal. The presence of HPV 6/11 in adult conjunctival papillomas might reflect a) an activation of a latent infection acquired as above, or b) a new infection transmitted from other mucosal sites, the genital tract included. The role of HPV in conjunctival dysplasias and malignant transformation is not clear as yet.
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Affiliation(s)
- M Mäntyjärvi
- Department of Ophthalmology, University of Kuopio, Finland
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26
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McDonnell JM, Mayr AJ, Martin WJ. DNA of human papillomavirus type 16 in dysplastic and malignant lesions of the conjunctiva and cornea. N Engl J Med 1989; 320:1442-6. [PMID: 2541337 DOI: 10.1056/nejm198906013202202] [Citation(s) in RCA: 131] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Human papillomaviruses are receiving attention for their role in the pathogenesis of cancer, especially cancer of the anogenital tract. Although strains of human papillomavirus are associated with benign lesions of the conjunctiva, their association with conjunctival dysplastic lesions and carcinomas has remained unclear. We examined a group of neoplastic lesions of the conjunctiva for the presence of DNA sequences for human papillomavirus types 16 and 18, using in vitro gene amplification with the polymerase chain reaction. Tissue specimens of five conjunctival dysplastic lesions and one invasive carcinoma and swab specimens of the mucosa of both corneas of a patient with unilateral corneal dysplasia contained DNA sequences related to human papillomavirus type 16. All dysplastic specimens examined were positive for DNA sequences. Viral DNA was not detected in six control specimens from patients with conjunctival melanoma, papilloma, nevus, or pterygium. We conclude that DNA from human papillomavirus type 16 is present in a substantial percentage of conjunctival premalignant and malignant lesions. It may play a part in the development of conjunctival dysplasia and carcinoma, as it does in cancers of certain other body sites.
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Affiliation(s)
- J M McDonnell
- Pathology Laboratory, Doheny Eye Institute, Los Angeles, CA 90033
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27
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Jenson AB, Lim LY, Singer E. Comparison of human papillomavirus type 1 serotyping by monoclonal antibodies with genotyping by in situ hybridization of plantar warts. J Cutan Pathol 1989; 16:54-9. [PMID: 2547854 DOI: 10.1111/j.1600-0560.1989.tb00011.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Thirty plantar warts were analyzed for the presence of HPV-1 type-specific and PV genus-specific capsid antigens by immunofluorescence (IF) using monoclonal and polyclonal antibodies and type-specific HPV-1 DNA employing in situ hybridization methods. Fifteen of 30 plantar warts were positive by IF for PV genus-specific structural viral antigens. Thirteen of the 15 productively infected plantar warts expressed intranuclear HPV-1 type-specific capsid antigens and viral DNA, which were detected in the same distribution in each individual wart. The 2 productively infected plantar warts that did not react with HPV-1 type-specific MoAbs did not react with HPV-1 type-specific DNA by in situ hybridization. Thus, serotyping of HPV-1 capsid antigens by monoclonal antibodies is concordant with genotyping of HPV-1 viral DNA by in situ hybridization in productively infected plantar warts.
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Affiliation(s)
- A B Jenson
- Department of Pathology, Georgetown University School of Medicine, Washington DC 20007
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28
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Condyloma Acuminatum. Sex Transm Dis 1989. [DOI: 10.1007/978-1-4612-3528-6_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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29
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McDonnell PJ, McDonnell JM, Kessis T, Green WR, Shah KV. Detection of human papillomavirus type 6/11 DNA in conjunctival papillomas by in situ hybridization with radioactive probes. Hum Pathol 1987; 18:1115-9. [PMID: 2824322 DOI: 10.1016/s0046-8177(87)80378-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Twenty-three conjunctival papillomas and 28 conjunctival dysplasias were examined for human papillomavirus (HPV)-DNA sequences by in situ hybridization with nick-translated 35S-labeled HPV probes. Adjacent paraffin sections were hybridized with HPV type 2, 6, 16, and 18 probes at Tm - 17 degrees C. Fifteen tissues, all papillomas, displayed positive hybridization with the HPV-6 probe. Infection with HPV-6 (or the closely related HPV-11) appeared to be responsible for most of the conjunctival papillomas of children and young adults. The presence of genital tract HPV-6 in these lesions suggests that some of the infections were acquired during passage through an infected birth canal. The lack of hybridization in adult conjunctival dysplasias indicates either that HPVs are not associated with this condition or that the probes and the technique utilized were not adequate for demonstration of this association.
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Affiliation(s)
- P J McDonnell
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD 21205
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Eversole LR, Laipis PJ, Merrell P, Choi E. Demonstration of human papillomavirus DNA in oral condyloma acuminatum. JOURNAL OF ORAL PATHOLOGY 1987; 16:266-72. [PMID: 2821213 DOI: 10.1111/j.1600-0714.1987.tb01491.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Condyloma acuminatum arising on oral mucous membranes exhibits distinct histopathological features that allow for differentiation from the more common squamous papilloma. These lesions are parakeratinized with cryptic invagination of cornified cells extending into an acanthotic spinous cell layer. Superficial spinous layer koilocytosis is a prominent feature and the condylomatous papillomas exhibit a tendency for sessile architecture. Among 62 instances, the average age was 39.7 years with a predilection for the 3rd and 4th decades. The male to female ration was 5.7:1 and the tongue, gingiva and lips were the favored sites. Whereas 25% of the evaluated cases demonstrated upper spinous layer papillomavirus common antigen immunoreactivity, DNA in situ hybridization under conditions of high stringency disclosed the presence of human papillomavirus Types 6, 11 or related genomes in 85% of the lesions. A single case was found to harbor human papillomavirus Type 2.
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Affiliation(s)
- L R Eversole
- Department of Oral Diagnostic Sciences, University of Florida, Gainesville 32610
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Green TL, Eversole LR, Leider AS. Oral and labial verruca vulgaris: clinical, histologic and immunohistochemical evaluation. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1986; 62:410-6. [PMID: 3464913 DOI: 10.1016/0030-4220(86)90290-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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34
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Bosniak SL, Novick NL, Sachs ME. Treatment of recurrent squamous papillomata of the conjunctiva by carbon dioxide laser vaporization. Ophthalmology 1986; 93:1078-82. [PMID: 3093950 DOI: 10.1016/s0161-6420(86)33634-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Complete resection of recurrent conjunctival squamous papillomata frequently may be exceedingly difficult, since such lesions are typically friable and multilobulated. Recurrent lesions often fill the fornicies and spill onto the lid margins. Moreover, since the human papillomavirus (HPV) has been linked to some of these lesions, there remains the further possibility of spread with "cold knife" resection. We discuss the benefits of carbon dioxide laser vaporization therapy for recurrent squamous papillomata of the conjunctiva that have not responded to resection and cryotherapy or topical immunotherapy. The carbon dioxide laser facilitates resection by providing a bloodless field, and reduces the possibility of viral seeding of the conjunctiva by sterilizing the operative site and sealing the lymphatics.
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Pfister H, Fuchs PG, Völcker HE. Human papillomavirus DNA in conjunctival papilloma. Graefes Arch Clin Exp Ophthalmol 1985; 223:164-7. [PMID: 2993107 DOI: 10.1007/bf02148894] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
A histologically proven conjunctival papilloma was examined for the presence of papillomavirus DNA by nucleic acid hybridization under relaxed conditions. It harbored papilloma-virus-specific DNA, which showed no detectable relationship with that of known virus types when tested under stringent conditions. This demonstrates that conjunctival papillomas are associated with more than one papillomavirus type. Viral diagnosis may turn out to be of prognostic value.
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36
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Abstract
Three new cases of lacrimal canalicular papillomatosis are reported and the total of 12 cases in the literature reviewed. They present with epiphora or a local mass. Multiple recurrences over many years is characteristic. A minority have papillomata of the conjunctiva or lacrimal sac. Histopathological examination shows a benign papilloma with a fibrovascular stalk. Treatment was either multiple excision or cryotherapy, but neither affected the rate of occurrence. A viral aetiology is postulated in some cases.
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