Zusammenfassung
Wir berichten über den Fall eines 36-jährigen Patienten mit einem klinisch ungewöhnlichen, therapierefraktären, subungual lokalisierten, stark verhornten, exophytisch wachsenden, großen verrukösen Tumor des Mittelfingers. Die histologische Untersuchung zeigte einen sehr dicken, papillomatös wachsenden, stark hyperkeratotischen epithelialen Tumor mit Koilozyten sowie zahlreichen Atypien und Mitosen. In der PCR-Analyse ließ sich im Tumor HPV 16 DNA nachweisen. Histologischer und virologischer Befund sprechen für die Diagnose eines „warty squamous cell carcinoma” unter dem klinischen Bild eines verrukösen Karzinoms vom Typ des Epithelioma cuniculatum. Beim vorliegenden Fall ist unseres Wissens erstmals ein „warty squamous cell carcinoma” der Hand beschrieben und erstmals HPV 16 DNA in einem „warty squamous cell carcinoma” bzw. verrukösen Karzinom der Hand nachgewiesen worden.
Abstract
We report on a 36-year old male patient with a clinically unusual treatment refractory subungual horny verrucous big size exophytic tumor of his third finger. Histology revealed a very thick papillomatory hyperkeratotic epithelial tumor with koilocytes and many atypic cells and mitoses. PCR analysis disclosed presence of HPV type 16 DNA in the tumor. Histological and virologic findings lead to the diagnosis of a warty squamous cell carcinoma. Clinically the lesions resembled a verrucous carcinoma of the epithelioma cuniculatum type. To our knowledge the presented case is the first reported warty carcinoma located at the hand and the first to demonstrate HPV 16 DNA in a warty squamous cell carcinoma or a verrucous carcinoma located at the hand.
Literatur
-
1
Aroni K, Lazaris A C, Iokaim-Liossi A, Paraskeavakou H, Davaris P S.
Histological diagnosis of cutaneous ”warty” carcinoma on a pre-existing HPV lesion.
Acta Dermatovenereol.
2000;
80
294-296
-
2 Braun-Falco O, Plewig G, Wolff H H. Dermatologie und Venerologie. 4. Aufl. Berlin, Heidelberg, New York; Springer 1996: 1317-1323
-
3
Cho N H, Joo H J, Ahn H J, Jung W H, Lee K G.
Detection of human papillomavirus in warty carcinoma of the uterine cervix: comparison of immunhistochemistry, in situ hybridization and in situ polymerase chain reaction methods.
Pathol Res Pract.
1998;
194
713-720
-
4
Collison D W, Mikhail G R.
Carcinoma cuniculatum of the hand.
Arch Dermatol.
1989;
125
1335-1336
-
5
Cubilla A L, Velazques E F, Reuter V E, Oliva E, Mihm M C, Young R H.
Warty (condylomatous) squamous cell carcinoma of the penis.
Am J Pathol.
2000;
24
505-512
-
6
Dobson C M, Azurdia R M, King C M.
Squamous cell carcinoma arising in a psoriatic nailbed: case report with discussion of diagnostic difficulty and therapeutic options.
Brit J Dermatol.
2002;
147
144-149
-
7
Forslund O, Nordin P, Hansson B G.
Mucosal human papillomavirus types in squamous cell carcinomas of the uterine cervix and subsequently on fingers.
Brit J Dermatol.
2000;
142
1148-1153
-
8
Forslund O, Nordin P, Andersson K, Stenquist B, Hansson B G.
DNA analysis indicates patient-specific human papillomavirus type 16 strains in Bowen's disease on fingers and in archival samples from genital dysplasia.
Brit J Dermatol.
1997;
136
678-682
-
9 Grossman D, Leffel D J. Squamous cell carcinoma. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI (Hrsg.) Fitzpatrick's dermatology in general medicine. 6. Aufl. New York, Chicago, San Francisco; McGraw-Hill 2003: 737-747
-
10
Knobler R M, Schneider S, Neumann R A, Bodemer W, Radlwimmer B, Aberer E, Söltz-Szöts J, Gebhart W.
DNA-dot-blot hybridization implicates human papillomavirus type 11 in epithelioma cuniculatum.
J Med Virol.
1989;
29
33-37
-
11
Marques M S, Mor M C, Bivar J M, Costa A.
Carcinoma cuniculatum da mao.
Med Cutanea Ibero Lat Am.
1986;
14
5-8
-
12
Martin F, Dalac S, Lambert D.
La carcinoma verruqueux. Situation nosologique, à propos des quatre cas.
Ann Dermatol Venereol.
1995;
122
399-403
-
13
McCormack D, Scannel T, Cunningham F.
Giant squamous cell carcinoma of the hand: epithelioma cuniculatum - a case report.
Irish J Med Sci.
1994;
163
379-380
-
14
McKee P H, Wilkinson J D, Black M M, Whimster I W.
Carcinoma (Epithelioma) cuniculatum: a clinico-pathological study of nineteen cases and review of literature.
Histopathol.
1981;
5
425-436
-
15
Meyer J, Wünscher U, Hünicke H.
Verruköses Karzinom (Ackermann).
Z Ärztl Fortb.
1988;
82
463-464
-
16
Mitsuishi T, Sata T, Matsurka T, Iwasaki T, Kawashima M.
The presence of mucosal papillomavirus in Bowen's disease of the hands.
Cancer.
1997;
79
1911-1917
-
17
Moy R L, Eliezri Y D, Nuovo G J, Zitteli J A, Bennet R G, Silverstein S.
Human papillomavirus type 16 DNA in periungual sqamous cell carcinomas.
J Am Med Assoc.
1989;
261
2669-2673
-
18
Neilson D, Dundas S, Page R.
Carcinoma cuniculatum of the hand.
J Hand Surg.
1988;
13
218-220
-
19
Noel J C, Peny M O, Detremmerie O, Verhest A, Heenen M, Thiry L, DeDobbeleer G.
Demonstration of human papillomavirus type 2 in a verrucous carcinoma of the foot.
Dermatology.
1993;
187
58-61
-
20
Noel J C, Sornin deLeysat C, Peny M O, van de Stadt J, Fayt I, DeDobbeleer G.
Warty carcinoma of the anus: a variant of squmous cell carcinoma associated with anal intraepithelial neoplasia and human papillomavirus infection.
Int J Clin Invest Dermatol.
2001;
203
262-264
-
21
Ostrow R S, Shaver M K, Turnquist S, Viksnins A, Bender M, Vance C, Kaye V, Faras A J.
Human papillomavirus-16 DNA in a cutaneous invasive cancer.
Arch Dermatol.
1989;
125
666-669
-
22
Piatelli A, Rubini C, Fioroni M N, Iezzi T.
Warty carcinoma of the oral mucosa in a HIV+ patient.
Oral Oncol.
2001;
37
665-667
-
23
Schell B J, Rosen T, Rády P, Arany I, Tschen J A, Mack M F, Tyring S K.
Verrucous carcinoma of the foot associated with human papillomavirus type 16.
J Am Acad Dermatol.
2001;
45
49-55
-
24
Schwartz R A.
Verrucous carcinoma of the skin and mucosa.
J Am Acad Dermatol.
1995;
32
1-21
-
25
Tosti A, Morelli R, Fanti P A, Morselli P G, Catanari S, Landi G.
Carcinoma cuniculatum of the nail apparatus: report of three cases.
Dermatology.
1993;
186
217-221
-
26
VanGeertruyden J P, Olemas C, Laporte M, Noel J C.
Verrucous carcinoma of the nail bed.
Foot Ankle Interntl.
1998;
19
327-328
-
27
Wagner G, Hey K.
Epithelioma cuniculatum - verruköses Karzinom der Fußsohle.
Akt Dermatol.
1997;
23
42-44
Prof. Dr. med. habil. L. Kowalzick
Klinik für Hautkrankheiten und Allergologie · Vogtland-Klinikum Plauen GmbH
Postfach 100153 · 08505 Plauen
Email: lutz.kowalzick@web.de
