Histopathology and Immunohistochemistry In Cases of Giant Perianal Condyloma Acuminata with Squamous Cell Carcinoma Transformation

Abstract

Giant Condyloma Acuminata (GCA) considered a histologically benign tumor that is locally aggressive but has the potential for destructive growth and a high recurrence rate. Unusual clinical presentations of GCA with rapid growth may indicate malignant transformation. Histopathological examination is necessary for the diagnosis of Condyloma Acuminata to observe cell changes and the level of invasiveness. The purpose of this case report is to discuss the importance of the histopathological approach and immunohistochemistry with P16 and P53 antibodies in patients with Giant Condyloma Acuminata (GCA) with suspected Squamous Cell Carcinoma (SCC) transformation. A case of 42-years-old male came to the clinic with a chief complaint of anal warts. On venereological examination, there were verrucous plaques, multiple, clear borders, irregular edges, measuring 7x4 cm with varying shapes and ulcers with an erythematous base, multiple, firm borders, irregular edges, varying shapes and sizes. Also, blood and mucopurulent discharge were obtained. The acetowhite test showed positive results.  On histopathological examination, the results showed hyperkeratosis, koilocyte cells, and invasion of the stroma. The histopathological examination was consistent with condyloma acuminata with a focus of SCC transformation. The patient underwent an immunohistochemical examination with P53 and P16 antibodies, the results were positive for P53 in 40% of tumor cells while P16 was negative. Histopathological examination is essential for the diagnosis of GCA, while immunohistochemical analysis can be employed to identify specific strains or antigens of HPV, which may expedite the evolution and progression of tumors from benign to malignant states. It can be concluded that GCA requires regular histopathological and immunohistochemical screening and examination for early detection of malignancy.