HPV-16 INFECTION IN A PATIENT WITH 2 PRIMARY SQUAMOUS-CELL CARCINOMAS- OF THE UTERINE CERVIX AND THE ANAL MUCOSA

A 43-year-old woman presented with metrorrhagia and a polypoid anal tu mor. Cervical dilatation and endocervical curettage and resection of t he anal tumor revealed two primary squamous cell carcinomas: of the ut erine cervix and the anal mucosa. HPV 16 was identified in both tumors using an in situ hybridization technique with probes against HPV 6, 1 1, 16, 18, 31 and 33. The cervical carcinoma was weakly positive for p 53 protein, whereas the anal tumor was p53 protein negative. Five year s later a recurrence of the cervical carcinoma was diagnosed and a hys terectomy was performed. Of 3,013 patients with squamous cell carcinom a of either the cervix or the anus registered in our files, only one h ad a primary carcinoma in both locations. It was concluded hat HPV 16- induced squamous cell carcinoma may occur simultaneously in the cervix and the anus, and carcinoma in either of the two locations has to be ruled out when dealing with HPV infection in the anogenital tract.