Warty carcinoma arising in condyloma acuminatum of urinary bladder - A case report

We describe the case of a 62-year-old man with chronic irritation of the ur inary bladder resulting in dysuria and hypogastric pain. Three neoplasms me asuring 0.5, 1, and 1.5 cm, respectively, were observed by cystoscopy and r emoved by transurethral resection (TUR). Histologic examination showed a co mplex folding of squamous hyperplastic epithelium around a connective tissu e core. The superficial epithelium contained numerous koilocytes. The doubl e polymerase chain reaction (PCR) detected DNA of type 11 human papillomavi rus (HPV). The diagnosis was condyloma acuminatum of bladder. Three months later the patient presented with fever, and a new cytoscopy demonstrated an ulcerated, exophytic 4.5 cm mass. Histopathology showed a squamous carcino ma with papillomatous structure, pronounced viral koilocytosis, and irregul ar invasive deep margin. BPV type 11 was found with double PCR. The diagnos is was warty carcinoma arising in condyloma acuminatum. To the best of our knowledge, this is the first case of warty carcinoma of the urinary bladder described in the literature. We discuss the relationship between the infec tion by HPV and the development of condyloma acuminatum, its evolution towa rd a well-differentiated squamous carcinoma, and its distinction from verru cous carcinoma.