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Elsayed NS, Wolfe AJ, Burk RD. Urine microbiome in individuals with an impaired immune system. Front Cell Infect Microbiol 2024; 13:1308665. [PMID: 38274734 PMCID: PMC10808152 DOI: 10.3389/fcimb.2023.1308665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
With the advent of next generation sequencing, it is now appreciated that human urine is not sterile. Recent investigations of the urinary microbiome (urobiome) have provided insights into several urological diseases. Urobiome dysbiosis, defined as non-optimal urine microbiome composition, has been observed in many disorders; however, it is not clear whether this dysbiosis is the cause of urinary tract disorders or a consequence. In addition, immunologically altered disorders are associated with higher rates of urinary tract infections. These disorders include immunoproliferative and immunodeficiency diseases, cancer, and immunosuppressant therapy in transplant recipients. In this review, we examine the current state of knowledge of the urobiome in immunologically altered diseases, its composition and metabolomic consequences. We conclude that more data are required to describe the urobiome in immune altered states, knowledge that could facilitate understanding the role of the urobiome and its pathophysiological effects on urinary tract infections and other disorders of the urinary tract.
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Affiliation(s)
- Noha S. Elsayed
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Alan J. Wolfe
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States
| | - Robert D. Burk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Departments of Microbiology and Immunology, Epidemiology and Population Health, and Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY, United States
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Tsuru I, Nakamura M, Izumi T, Ono A, Miura S, Morikawa T, Shigehara K, Kitamura T, Kume H, Shiga Y. A case of condyloma acuminatum of the bladder concurrently diagnosed with urothelial carcinoma. IJU Case Rep 2024; 7:42-45. [PMID: 38173455 PMCID: PMC10758899 DOI: 10.1002/iju5.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/21/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Condyloma acuminatum usually occurs in the external genitalia and rarely in the bladder mucosa. Here, we report a case of condyloma acuminatum of the bladder that was detected concurrently with urothelial carcinoma. Case presentation A 42-year-old man was referred to our urology department with positive urine cytology for urothelial carcinoma. Cystoscopy revealed a broad-base nonpapillary bladder tumor. The patient underwent a transurethral resection of the bladder tumor. Pathological examination revealed urothelial carcinoma, high-grade pT1, and concurrent resection of condyloma acuminatum. DNA was extracted from the paraffin-embedded transurethral resection of the bladder tumor tissue specimens. HPV11 was detected in condylomas by PCR and in situ hybridization, whereas HPV was not detected in urothelial carcinomas. Conclusion We report a rare case of condyloma acuminatum of the bladder that was concurrently diagnosed with urothelial carcinoma from the same site.
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Affiliation(s)
- Ibuki Tsuru
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | | | - Taro Izumi
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Akihiro Ono
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Sakiko Miura
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Teppei Morikawa
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and UrologyKanazawa University Graduate School of Medical ScienceKanazawaJapan
| | | | - Haruki Kume
- Department of UrologyThe University of Tokyo hospitalTokyoJapan
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Taylor AS, Acosta AM, Al-Ahmadie HA, Mehra R. Precursors of urinary bladder cancer: molecular alterations and biomarkers. Hum Pathol 2023; 133:5-21. [PMID: 35716731 DOI: 10.1016/j.humpath.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 01/04/2023]
Abstract
Clinical surveillance and follow-up of patients diagnosed with or at risk for urinary bladder cancers represent long-term, invasive, and costly processes for which supplemental biomarker information could help provide objective, personalized risk assessment. In particular, there are several precursors and possible precursors to urinary bladder cancer for which clinical behavior is heterogenous and interobserver variability in histopathologic diagnosis make it difficult to standardize management. This review seeks to highlight these precursor lesions from a diagnostic perspective (including flat urothelial lesions, papillary urothelial lesions, squamous lesions, and glandular lesions) and qualify known multiomic biomarkers that may help explain their behavior, predict patient risk, and acknowledge the nuance inherent to the question of whether these lesions are "benign" or "preneoplastic."
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Affiliation(s)
- Alexander S Taylor
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Andres M Acosta
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI 48109, USA; Michigan Center for Translational Pathology, Ann Arbor, MI 48109, USA.
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Whitaker JA. Condyloma acuminatum of the urinary bladder with underlying squamous cell carcinoma: a case report. J Med Case Rep 2022; 16:449. [PMID: 36457102 PMCID: PMC9714249 DOI: 10.1186/s13256-022-03669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Condyloma acuminatum is a rare finding of the urinary bladder. There are many morphological variants that exist. It has been previously reported that some of these variants were found to be associated with subsequent or concurrent squamous cell carcinoma. However, there are limited cases that describe this underlying malignancy found in patients with bladder condyloma. CASE PRESENTATION A 38-year-old African American female presented with condyloma acuminatum of the urinary bladder and underlying squamous cell carcinoma, which also invaded the neighboring uterus, urethra, and anterior vagina. Initial attempts at treatment began with cystoscopic resection of the condyloma; however, due to diffuse transformation, we pursued radical cystectomy with adjuvant chemotherapy and radiation. CONCLUSION As such a finding is rare in the urinary bladder, with few reports discussing its association with ensuing squamous cell carcinoma, we hope that this continues to generate awareness and consideration in the treatment of affected individuals.
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Affiliation(s)
- John A. Whitaker
- grid.410721.10000 0004 1937 0407School of Medicine, University of Mississippi Medical Center, Jackson, MS USA ,grid.410721.10000 0004 1937 0407Department of Urology, University of Mississippi Medical Center, Jackson, MS USA ,grid.241167.70000 0001 2185 3318Department of General Surgery, Wake Forest University, Winston-Salem, USA
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Velez Torres JM, Zhao J, Epstein JI, Kryvenko ON. Condyloma acuminatum of the urinary tract demonstrates atypical squamous cells in urine cytology. Hum Pathol 2022; 130:110-116. [PMID: 36244465 DOI: 10.1016/j.humpath.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/21/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022]
Abstract
Urine cytology of urinary tract condylomas has not been systematically studied. We analyzed cytologic features of urinary tract condylomas and evaluated potential diagnostic challenges and pitfalls. We retrospectively reviewed urine cytology of urinary tract condylomas from 2 academic institutions (2015-2022). Among 20 patients with urinary tract condylomas, 6 had urine cytology (2 samples in 1 patient), including 3 men and 3 women (mean age, 74.3 years; range, 65-86 years). Original interpretations were negative for high-grade urothelial carcinoma (NHGUC; n = 4), atypical urothelial cells (n = 1), reactive urothelial cells (n = 1), and negative for malignancy (n = 1). Squamous cells were noted in 3 cases, atypical squamous cells (ASC) consistent with low-grade squamous intraepithelial lesion (LSIL) were noted in 1 case, and in 3 cases, the presence of squamous cells was not mentioned. All urines were reclassified according to The Paris System as NHGUC. Specimens were composed of benign urothelial cells and groups or isolated ASC consistent with LSIL (n = 4), atypical keratinized squamous cells (n = 2), and ASC that did not meet LSIL criteria (n = 1). The LSIL cells showed nuclear enlargement (n = 4), hyperchromasia (n = 4), perinuclear halo (n = 3), nuclear membrane irregularity (n = 4), orangeophilic cytoplasm (n = 3), and binucleation (n = 4). The atypical keratinized squamous cells showed hyperchromasia (n = 2), nuclear membrane irregularity (n = 2), keratin pearls (n = 2), and binucleation (n = 1). The ASC that did not meet LSIL criteria showed nuclear enlargement and orangeophilic cytoplasm. Many urinary tract condylomas (57%) demonstrate classic LSIL features in urine cytology. Less frequent cases can mimic keratinizing squamous cell carcinoma (28%) or demonstrate ASC not diagnostic of LSIL (15%).
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Affiliation(s)
- Jaylou M Velez Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Jianping Zhao
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21205, USA
| | - Jonathan I Epstein
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21205, USA; Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21205, USA; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21205, USA
| | - Oleksandr N Kryvenko
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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Pang L, Ding Z, Li F, Chai H, Wu M, Shao J. HPV-16 Expression and Loss of Cell Differentiation in Primary Bladder Tumors. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6565620. [PMID: 36281460 PMCID: PMC9587909 DOI: 10.1155/2022/6565620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022]
Abstract
Objective Primary bladder tumors have a high degree of malignancy. To investigate the expression of human papillomavirus type 16 (HPV-16) in primary bladder tumors and the loss of cell differentiation and to explore the significance of HPV-16 detection, it is expected to be a disease. Treatment provides a theoretical basis. Methods Fifty-seven patients with primary bladder tumors admitted to our hospital from January 2019 to January 2022 were selected as the research subjects, and they were divided into HPV-related groups according to the human papillomavirus (HPV) infection status (n = 28) and HPV unrelated group (n = 29). The general data of patients were collected, the expression of HPV-16 in bladder tissue samples was detected, and the correlation between pathological parameters and HPV-16 expression was analyzed. Results Among HPV subtypes, HPV 16 subtype accounted for the highest proportion, followed by HPV-18 and HPV-6 subtypes; there was no significant difference in tumor stage (stage 1, stage a, stage 2a) between the HPV-related group and the HPV-unrelated group (stage 1, stage a, and stage 2a). P > 0.05); there was no significant difference in postoperative pathological expression (high expression and low expression) of patients (P > 0.05); there was no statistical difference in age and gender between HPV-related and HPV-unrelated groups (P > 0.05), HPV-related group and HPV-unrelated group compared daily regular drinking and smoking status, the difference was statistically significant (P < 0.05); HPV-16 expression was not correlated with tumor differentiation degree and age of patients (P > 0.05); the area under the curve (AUC) of HPV-16 for judging primary bladder tumor expression and cellular molecular deletion was 0.891, with a sensitivity of 83.94% and a specificity of 88.57%. Conclusion HPV-16 is an upper, expressed in primary bladder tumors and will participate in the differentiation and loss of cells, which can provide effective guidance and basis for the diagnosis of primary bladder tumors, which is an important factor for judging the pathological stage and prognosis of patients and can provide a theoretical reference for the formulation of therapeutic measures.
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Affiliation(s)
- Lei Pang
- Department of Urology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), No. 29 Shuangta East Street, Yingze District, Taiyuan, Shanxi 030012, China
| | - Zijun Ding
- Department of Neonatology, Shanxi Children's Hospital, No. 13 North Xinmin Street, Xinghualing District, Taiyuan, Shanxi 030013, China
| | - Fei Li
- Department of Urology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), No. 29 Shuangta East Street, Yingze District, Taiyuan, Shanxi 030012, China
| | - Hongqiang Chai
- Department of Urology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), No. 29 Shuangta East Street, Yingze District, Taiyuan, Shanxi 030012, China
| | - Ming Wu
- Department of Urology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), No. 29 Shuangta East Street, Yingze District, Taiyuan, Shanxi 030012, China
| | - Jinkai Shao
- Department of Urology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), No. 29 Shuangta East Street, Yingze District, Taiyuan, Shanxi 030012, China
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Zhan M, Tong Z, Chen S, Miao Y, Yang Y. Establishing a prediction model for recurrence of condyloma acuminatum. Eur J Med Res 2022; 27:183. [PMID: 36138469 PMCID: PMC9494849 DOI: 10.1186/s40001-022-00816-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
We collected the clinical data of 156 patients diagnosed with condyloma acuminatum (CA), including age, gender, marriage, education level, stay up late, smoking, drinking, number of sexual partners, HPV infection status of sexual partners, genitourinary and anal diseases, condom use, other diseases of HPV infection, location and number of warts, HPV typing, etc. Analyze the risk factors affecting the recurrence of CA, explore the influencing factors and independent influencing factors of CA recurrence, establish the prediction model of CA recurrence, and evaluate its prediction value. Univariate analysis showed that stay up late, HPV infection status of sexual partners, urogenital diseases, condom use, other diseases of HPV infection and the number of CA were the influencing factors of CA recurrence. Multivariate analysis showed that condom use (OR = 0.166), HPV infection status of sexual partners (OR = 4.848), number of warts (OR = 1.212) and urogenital diseases (OR = 3.179) were independent factors affecting the recurrence of CA (P < 0.05). Therefore, the prediction model of CA recurrence can be established, and the area under the curve AUC of the prediction model was calculated to be 0.867 (95% CI 0.812–0.923). The model established in this study has certain prediction value for the recurrence of CA and can be used to preliminarily predict the recurrence of CA.
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Affiliation(s)
- Mengyun Zhan
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China
| | - Zhenzhen Tong
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China
| | - Song Chen
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yu Miao
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yun Yang
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China.
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Muresu N, Di Lorenzo B, Saderi L, Sechi I, Del Rio A, Piana A, Sotgiu G. Prevalence of Human Papilloma Virus Infection in Bladder Cancer: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12071759. [PMID: 35885662 PMCID: PMC9318826 DOI: 10.3390/diagnostics12071759] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
The etiology of bladder cancer is known to be associated with behavioral and environmental factors. Moreover, several studies suggested a potential role of HPV infection in the pathogenesis with controversial results. A systematic review was conducted to assess the role of HPV. A total of 46 articles that reported the prevalence of HPV infection in squamous (SCC), urothelial (UC), and transitional cell carcinomas (TCC) were selected. A pooled prevalence of 19% was found, with a significant difference in SCC that was mainly driven by HPV-16. Moreover, infection prevalence in case-control studies showed a higher risk of bladder cancer in HPV-positive cases (OR: 7.84; p-value < 0.00001). The results may suggest an etiologic role of HPV in bladder cancer. HPV vaccine administration in both sexes could be key to prevent the infection caused by high-risk genotypes.
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Affiliation(s)
- Narcisa Muresu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.M.); (I.S.)
| | - Biagio Di Lorenzo
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (B.D.L.); (L.S.); (G.S.)
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (B.D.L.); (L.S.); (G.S.)
| | - Illari Sechi
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.M.); (I.S.)
| | - Arcadia Del Rio
- Department of Biomedical Science, University of Sassari, 07100 Sassari, Italy;
| | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.M.); (I.S.)
- Correspondence:
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (B.D.L.); (L.S.); (G.S.)
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Hermans T, Grosse Siemer R, von Rundstedt FC. Intravesical ichthyosis: a rare case report. BMC Urol 2021; 21:177. [PMID: 34920717 PMCID: PMC8680048 DOI: 10.1186/s12894-021-00939-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ichthyosis is a rare skin disorder, in which the shedding of squamous cells is altered. Intravesical ichthyosis is an extremely rare condition. There is evidence for an association with intravesical condylomata accuminata, caused by urogenital infections of the human papilloma virus. These lesions are generally benign but known to be of a carcinogenic potential and therefore should be treated immediately and followed-up closely. CASE PRESENTATION We present the case of a 39-year-old woman who presented with recurrent urinary tract infections. During cystoscopy diffuse black pigmented flat bladder tumours were visualized. After transurethral resection the pathological report diagnosed an ichthyosis vesicae. CONCLUSION We recommend a complete resection with frequent clinical and cystoscopic follow-up. Furthermore, testing for the human papilloma virus should be performed and a vaccination should be offered to the patient. As ichthyosis vesicae is a rare phenomenon, there is an evident lack of clinical data regarding therapy, prognosis and follow-up. With our report, we want to emphasize the need for further research.
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Affiliation(s)
- T Hermans
- Department of Urology, Helios University Clinic Wuppertal, Heusnerstrasse 40, 42283, Wuppertal, Germany.
| | - R Grosse Siemer
- Department of Urology, Helios University Clinic Wuppertal, Heusnerstrasse 40, 42283, Wuppertal, Germany
| | - F C von Rundstedt
- Department of Urology, Helios University Clinic Wuppertal, Heusnerstrasse 40, 42283, Wuppertal, Germany
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Gellrich AL, Eraky A, Hamann C, Hügelmann K, Matthias M, Trentmann J, Osmonov D. [Cystectomy of a young patient with squamous cell metaplasia of the bladder and manifestation of condyloma]. Aktuelle Urol 2021; 54:223-227. [PMID: 34734393 DOI: 10.1055/a-1419-7822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Interdisciplinary managed case of a 29-Year-old patient with massive condylomas of the vulva and papillary squamous cell metaplasia of the bladder, leads after years of chronic cystitis and obstruction with meatus plastic and laser treatment to cystectomy with conduit and partial vulvectomy. After long lasting HPV infection with condyloma we also found a squamous cell carcinoma (pT1 G1) of the vulva.
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Affiliation(s)
- Antonin L. Gellrich
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Ahmed Eraky
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Claudius Hamann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Konrad Hügelmann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Micaela Matthias
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Jens Trentmann
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Daniar Osmonov
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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11
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Clinical Efficacy of Carbon Dioxide Laser Combined with ALA Photodynamics in the Treatment of Condyloma Acuminatum. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:7211055. [PMID: 34707674 PMCID: PMC8545531 DOI: 10.1155/2021/7211055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022]
Abstract
'Purpose. To observe the clinical efficacy and safety of carbon dioxide laser combined with ALA photodynamics in the treatment of condyloma acuminatum. Method. A total of 211 patients with condyloma acuminatum admitted to our hospital from April 2018 to June 2021 were selected as the observation object. They were divided into the intervention group (CO2 laser combined with ALA photodynamic therapy, 125 cases) and conventional group (CO2 laser treatment, 86 cases), and the efficacy and incidence of adverse reactions between the two groups were compared. Result. The total effective rate of the intervention group (96.00%) was significantly higher than that of the conventional group (84.88%) (P < 0.05). The total incidence of adverse reactions in the intervention group (8.00%) was lower than that in the conventional group (32.56%) (P < 0.05). Univariate analysis showed that the patient's smoking history, drinking history, course of disease, wart area, and number of sexual partners were related to the short-term prognosis (P < 0.05). Multivariate logistic regression analysis showed that the patient's course of disease, the area of the wart body, and the number of sexual partners were independent factors affecting the prognosis of patients with condyloma acuminatum (P < 0.05). Conclusion. Carbon dioxide laser combined with ALA dynamics treatment of condyloma acuminatum significantly improves the clinical efficacy, does not increase the incidence of adverse reactions, and has important clinical therapeutic value. The course of the disease, the area of the wart, and the number of sexual partners are independent factors affecting the prognosis of patients with condyloma acuminatum.
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Montoya-Cerrillo D, Briski LM, Jorda M, Kryvenko ON. Utility of GATA-3 and Cytokeratin 5/6 Immunostains in Separating Condyloma Acuminatum Arising in the Urinary Tract From Non-Invasive Papillary Urothelial Carcinoma. Int J Surg Pathol 2021; 30:260-264. [PMID: 34665053 DOI: 10.1177/10668969211052235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Condyloma acuminatum is a squamous epithelial lesion which uncommonly involves the urinary tract. In this location, non-invasive papillary urothelial carcinoma constitutes one of the main differential diagnoses with significant prognostic and therapeutic implications. To date, no ancillary immunohistochemical stain has been described to differentiate these two entities. We assess the utility of cytokeratin 5/6 (CK5/6) and GATA-3 immunohistochemistry in distinguishing condyloma acuminatum from non-invasive papillary urothelial carcinoma. Design We reviewed 9 condylomata acuminata involving the urinary tract, 12 low-grade and 8 high-grade non-invasive papillary urothelial carcinomas. CK5/6 immunostaining was performed in all cases. GATA-3 immunostaining and low-risk human papilloma virus (HPV) chromogenic in situ hybridization was performed in all condyloma cases and 2 urothelial carcinomas with squamous differentiation. Results 8/9 condylomata acuminata were positive for low-risk HPV. All condylomata acuminata exhibited strong full-thickness cytoplasmic staining for CK5/6. In 10 of 12 low-grade non-invasive papillary urothelial carcinomas, CK5/6 expression was continuous and limited to the basal cell layer, while it was patchy and limited to the basal cell layer in all 8 high-grade non-invasive papillary urothelial carcinomas. Two low-grade non-invasive papillary urothelial carcinomas showed focal full-thickness CK5/6 expression in the areas of squamous differentiation. These 2 cases were negative for low-risk HPV. GATA-3 immunostaining was positive in all condylomata acuminata. Conclusions CK5/6 immunostaining is a useful and simple tool that can help separate low-grade and high-grade non-invasive papillary urothelial carcinomas from condyloma acuminatum involving the urothelium-lined organs. GATA-3 has no discriminatory role between condyloma acuminatum and papillary urothelial carcinomas.
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Affiliation(s)
| | | | - Merce Jorda
- University of Miami Miller School of Medicine, Miami, FL, USA
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13
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Espinal Alvarez FF, Marquez Lavenant W, Mendez Morente LI, Ahumada Palma A. Intravesical Condyloma Acuminata Progressing to Squamous Cell Carcinoma of the Bladder: An Unusual Presentation. Cureus 2021; 13:e18259. [PMID: 34712534 PMCID: PMC8542405 DOI: 10.7759/cureus.18259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the bladder resulting from condyloma acuminata (CA) is uncommon. Most cases of SCC are asymptomatic until an advanced stage making the diagnosis difficult. Most patients present with urinary symptoms. We present the case of a 31-year-old African American male who presented to the emergency department with right lower extremity deep vein thrombosis. His past medical history was significant for recurrent bladder and urethral CA with high-grade dysplasia. A computed tomography (CT) gave the incidental findings of pelvic and bladder masses. The masses were studied and came back concerning for malignancy. The patient will undergo surgical removal soon. This manuscript illustrates an unusual presentation of CA progressing to SCC, including the diagnostic approach and treatment. We hope to increase awareness of the clinical presentation and regular follow-up in patients with risk factors.
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Kim CJ, Campbell SP, Allkanjari A, Lentz AC. Update on the Medical and Surgical Management of Urethral Condyloma. Sex Med Rev 2021; 10:240-254. [PMID: 33752995 DOI: 10.1016/j.sxmr.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/23/2021] [Accepted: 01/24/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Condyloma acuminata (CA) of the urethra presents a management challenge due to high recurrence rates, difficulty in accessing urethral lesions, risk of stricture formation, and potential for sexual dysfunction. While standard treatment modalities are acceptable for some external genital condyloma, they are not always feasible or appropriate for urethral lesions. OBJECTIVES We sought to review the literature on epidemiology, presentation, diagnosis and treatment of urothelial CA with a focus on surgical treatment options. METHODS We performed a comprehensive literature search of PubMed to identify all studies pertaining to urethral CA through November 2020. RESULTS Urethral CA is a relatively rare, but challenging disease to manage with a considerable amount of treatment side effects and downstream morbidity associated. In our comprehensive review we have found a wide selection of treatment modalities ranging from minimally invasive strategies to surgical reconstructive techniques. Proper follow-up to monitor for disease recurrence at the 3-4 month mark is appropriate and will determine subsequent treatment strategies as needed. Future studies and treatment directions include novel drug delivery models to optimize minimally invasive topical drug efficacy. CONCLUSION Treatment of urethral CA should be approached in a step-wise fashion. Medical therapy would be an appropriate option for asymptomatic or minimally symptomatic patients with small lesions who desire to avoid any interventions. If patient is symptomatic, has extensive disease burden or has failed medical therapy intervention should be considered with options including PDT, laser ablation or surgical excision with or without urethral reconstruction. Appropriate selection depends on patient characteristics and preferences along with prior treatment history. Kim CJ, Campbell SP, Allkanjari A, et al. Update on the Medical and Surgical Management of Urethral Condyloma. Sex Med Rev 2021;xxx:xxx-xxx.
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Affiliation(s)
- Christopher J Kim
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Scott P Campbell
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Armand Allkanjari
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Aaron C Lentz
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA.
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Xu H, Shen Q, Fan B, Xi C, Wang L. Effectiveness of a combination therapy of traditional Chinese medicine and CO 2 laser treatment for condyloma acuminatum. J Med Virol 2020; 92:3889-3894. [PMID: 32320078 DOI: 10.1002/jmv.25923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Condyloma acuminatum (CA) is both highly infectious and frequently recurring and requires long-term, repeated treatments, which seriously affect the physical and psychological health of patients. The purpose of the present study was to investigate the effectiveness of a combination therapy of traditional Chinese medicine and CO2 laser on CA and the relationship between CA relapse and cellular immunity. METHODS The study cohort consisted of 160 CA patients who underwent ambulatory treatment between January 2017 and January 2019 in the Department of Dermatology and Venerology of our hospital. The 160 patients were randomly divided into two groups: a combination therapy group (80 cases), who underwent CO2 -laser treatment followed by three courses of oral traditional Chinese medicine and a control group (80 cases), who were only treated with the CO2 laser to remove warts. The efficacy of the CO2 -laser treatment was evaluated on the first month after treatment and relapse was evaluated at monthly follow-ups for 6 months. Additionally, 20 normal volunteers were also recruited. Three months before and after treatment, the cellular immunity factors of peripheral blood T lymphocyte subsets, including CD4+, CD8+, CD4+/CD8+, and interleukin-2 (IL-2), were detected and compared between CA patients and normal volunteers, the combination therapy and control groups, and the relapse and cure groups to determine whether there were statistical differences. RESULTS Compared with normal volunteers, CA patients exhibited lower CD4+, CD4+/CD8+, and IL-2 levels and higher CD8+ levels (P < .05). In addition, the rates of relapse for the combination therapy and control groups were 25.7% and 40.8%, respectively. However, the comprehensive immunity factors showed no statistical difference (P > .05) before treatment. Three months after treatment, factors including CD4+ and CD4+/CD8+ were higher in the combination therapy group than in the control group (P < .05), and CD8+ and IL-2 showed no statistical difference (P > .05); factors including CD4+, CD4+/CD8+, and IL-2 were higher and CD8+ was lower in the cure group than in the relapse group (P < .05). CONCLUSION The therapy combination of traditional Chinese medicine and CO2 -laser treatment can reduce the relapse rate of CA. It might be that traditional Chinese medicine combined with CO2-laser treatment regulate liver meridian, Qi and blood, and restore the balance between various subgroups.
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Affiliation(s)
- Huaxiang Xu
- Department of the Medical Cosmetology, Jiangxi Provincial People's Hospital, Nanchang, China
- Department of Dermatology & STD, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Qinglin Shen
- Institute of Clinical Medicine, Institute of Clinical Medicine, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Bing Fan
- Department of Radiology, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Changqing Xi
- Department of Traditional Chinese Medicine, Yichang Yiling Hospital, Yichang, China
| | - Lili Wang
- Department of Dermatology & STD, Yichang Yiling Hospital, Yichang, China
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Siliquini N, Viola R, Giura MT, Fierro MT, Ribero S, Ortoncelli M. Case of bladder cancer during Dupilumab therapy: Just an incidental event? Dermatol Ther 2020; 33:e13854. [PMID: 32543732 DOI: 10.1111/dth.13854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Niccolò Siliquini
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Maria Teresa Giura
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria Teresa Fierro
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Michela Ortoncelli
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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