Verrucous carcinoma of the cervix in a case with uterine prolapse

Abstract 

Verrucous carcinoma of the female tract is rare. We present a case involving association of verrucous carcinoma of the cervix with uterine prolapse. A 86-year-old woman was admitted with postmenopausal vaginal bleeding. The gynecologic examination revealed the uterine prolapse with a exophytic tumorous mass (3 × 6 × 8 cm) on the cervix. A punch biopsy was taken from the tumor, which revealed coilocytotic and mild dysplastic changes in the squamous epithelium; invasion of the underlying stroma could not be evaluated. A cervical swab was tested for human papillomavirus (HPV) DNA using the polymerase chain reaction, and HPV type 31 was detected. The tumorous mass was totally excised. The histopathologic diagnosis was consistent with verrucous carcinoma of the cervix: exophytic lesion was composed of thickened, acanthotic papillary squamous epithelium with mild dysplasia and diffuse parakeratosis, and no obvious invasion was observed. The patient was periodically controlled by pelvic examination and was free of progressive disease at 6 months. The diagnosis and treatment of verrucous carcinoma of the cervix may be difficult in some cases. The presence of HPV type 31 in our case might indicate the possibility that HPV is the etiology of this neoplasm.

Keywords: Verrucous carcinoma, HPV type 31, Uterine prolapse, Cervix