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Thomas Flaig, MD


Rare Case of Condyloma Acuminatum in the Bladder, Surrounding Areas

By: Vanessa A. Carter, BS
Posted: Thursday, January 19, 2023

In the Journal of Medical Case Reports, John A. Whitaker, MD, of the University of Mississippi Medical Center, Jackson, presented a case of Condyloma acuminatum (anogenital warts) of the urinary bladder with underlying squamous cell carcinoma. The results of this study suggest that since this manifestation of human papillomavirus seems to correlate with carcinoma in situ or squamous cell carcinoma of the bladder, patients diagnosed with this ailment should be monitored closely for underlying malignancy.

A 38-year-old woman with no substantial medical history presented with a large bladder mass found on previous imaging. Symptoms at presentation consisted of urinary tract infections, occasional stress urinary incontinence, and intermittent spotting. Further CT scan showed the mass occupying a significant portion of the posterior bladder, as well as invading the cervix and uterus. Bilateral hydroureteronephrosis was also observed.

The patient underwent cystoscopy with bilateral stent placement, during which a biopsy sample was taken from lesions of the bladder and left labia. Pathology results revealed findings consistent with low-grade squamous intraepithelial lesion of the cervix and Condyloma acuminatum.

Transurethral resection of the mass was planned and subsequently canceled because of diffuse transformation involving the urethra. The patient was deemed unsuitable for bladder salvage therapy and therefore underwent radical cystectomy with neobladder creation and self-catheterizable stoma; she later underwent a hysterectomy with biopsy. Ultimately, final pathology results detected atypical Condyloma proliferation of the urinary bladder wall and squamous cell carcinoma of the urinary bladder, urethra, and anterior vagina.

The discovered malignancy was deemed stage IIIA and grade 1 on account of the Condyloma extending beyond the uterus and microscopic residual tumor margins of the urethra. Clinicians deliberated whether to begin adjuvant chemotherapy, and the patient ultimately initiated chemotherapy and radiation therapy. At the time of publication, the patient is being managed with surveillance imaging and has shown no sign of disease recurrence.

Disclosure: Dr. Whitaker reported no conflicts of interest.

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