Anogenital
squamous cell carcinoma has been noted with increased frequency in HIV-seropositive patients.
Verrucous carcinoma is a variant of
squamous cell carcinoma that tends to be locally invasive and non-metastasizing. Although human papillomavirus (HPV) has been strongly implicated in other squamous
neoplasms, it has been variably associated with
verrucous carcinoma and has not been examined in these lesions in the HIV-positive population. The aim of this study was to examine the association of HPV with anal
verrucous carcinoma in patients with the human immunodeficiency virus (HIV). HPV
DNA in situ hybridization for HPV Types 6/11, 16/18, and 31/33/35 was performed on
formalin-fixed,
paraffin-embedded tissue from six cases of
verrucous carcinoma and four cases of condyloma acuminatum in perianal specimens from HIV-seropositive patients. HPV DNA sequences were identified in five of six cases of
verrucous carcinoma and in all cases of condyloma acuminatum. Of the five
verrucous carcinomas that harbored detectable HPV
DNA, four contained HPV 6/11 and two contained HPV 16/18. One contained both HPV 6/11 and HPV 16/18. All four cases of condyloma acuminatum were positive for HPV 6/11. One patient included in this series had three chronologically separate
verrucous carcinomas. The initial lesion was negative for HPV
DNA. Subsequent
verrucous carcinomas were positive for HPV type 6/11 and type 16/18, respectively. The data presented support the concept that
verrucous carcinoma in the HIV-seropositive population is associated with HPV, which may indeed play an important role in its pathogenesis.