BILATERAL PRIMARY OVARIAN SQUAMOUS-CELL CARCINOMA-ASSOCIATED WITH HUMAN PAPILLOMA-VIRUS INFECTION AND VULVAR AND CERVICAL INTRAEPITHELIAL NEOPLASIA - A CASE-REPORT WITH REVIEW OF THE LITERATURE

Primary squamous cell carcinoma of the ovary is rare. Most cases repre sent malignant transformation of ovarian teratomas. Other cases are as sociated with preexisting Brenner tumor or ovarian endometriosis. We r eport a primary ovarian squamous cell carcinoma in a 40-year-old woman . The patient had recurrent high-grade intraepithelial neoplasia of th e vulva (VIN) and recurrent high-grade cervical intraepithelial neopla sia (GIN). Human papilloma virus (HPV) DNA 16/18 was identified in an in situ and invasive carcinoma in the left ovary; CIN and VIN were ide ntified with in situ hybridization with biotinylated DNA probes, Revie w of the literature revealed nine cases of primary ovarian squamous ce ll carcinoma not associated with a preexisting ovarian lesion. Three c ases were not associated with CIN and occurred in women who ranged in age from 64 to 90 years and did not have carcinoma in situ component. Six cases were associated with GIN, had a carcinoma in situ, and occur red in younger women ranging from 33 to 54 years of age. Our case belo nged to the latter category. This report raises the possible causal re lationship of HPV with primary ovarian squamous carcinoma in the group of middle-aged patients with CIN.