medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 12

<< Back Next >>

Ginecol Obstet Mex 2019; 87 (12)

Seborrheic keratoses in the recto-uterine pouch: Case report

Gómez-Londoño M, Echavarría-Restrepo LG, Gutiérrez-Sanmartín JM, Merino-Correa SC, Henao CP, Sanín-Ramírez D

Language: Spanish
References: 15
Page: 842-845
PDF size: 259.98 Kb.


ABSTRACT

Background: Thera are few repots of intraepithelial neoplasms with origins in the cervix or vagina with squamous appearance. This kind of lesions have been classified because of their morphologic similarities, in the category of “seborrheic keratoses like”. When seborrheic keratoses appears in the vaginal or vulvar mucosa, it has to be differentiated from low and high grade intraepithelial squamous lesions.
Objective: To describe a case of seborrheic keratoses in the recto-uterine pouch.
Clinical case: 70 years old patient, who underwent surgery for stress urinary incontinence with a sub-urethral sling. During the procedure, a lesion in the vaginal mucosa was detected, specifically in the recto-uterine pouch, of 1.2 x 1 cm length, with a light brown color and soft consistency. A specimen was taken from the lesion during the procedure for histopathological study, which reported: hyperkeratosis in the epidermis, regular acanthosis, thickening and anastomosis of the crests with formation of corneal pearls, dermis with inflammatory, chronic, perivascular infiltration, with no signs of malignancy. The diagnosis was hypertrophic seborrheic keratoses, positive for P16 stain which orients to HPV infection. The lesion was removed and the patient continued follow up with her primary care provider.
Conclusions: Seborrheic keratoses in this location is uncommon, with few reports in literature. These lesions are usually benign and are associated to HPV of low risk.


REFERENCES

  1. Fuste V, et al. Primary squamous cell carcinoma of the vagina: human papillomavirus detection, p16 (INK4A) overexpression and clinicopathological correlations. Histopathology. 2010; 57: 907-16. doi: 10.1111/j.1365- 2559.2010.03727.x.

  2. Hennell C, et al. Inverted papiloma of the cervix and vagina: report of 2 cases of a rare lesion associated with human papillomavirus 42. Hum Pathol. 2012; 43: 435-9. doi: 10.1016/j.humpath.2011.03.011.

  3. Talia Kl, McCluggage WG. Seborrheic keratosis-like lesions of the cervix and vagina: report of a new entity possibly related to low-risk human papillomavirus infection. Am J Surg Pathol. 2017; 41: 517-24. doi: 10.1097/ PAS.0000000000000762.

  4. Snd FL, Thomsen SF. Skin diseases of the vulva: eczematous diseases and contact urticaria. J Obstet Gynaecol 2018; 38: 295. doi: 10.1080/01443615.2017.1329283.

  5. Lynch PJ, et al. 2006 ISSVD Classification of vulvar dermatoses: pathologic subsets and their clinical correlates. J Reprod Med.2007; 52: 3-9.

  6. Yang EJ, et al. Vulvar and anal intraepithelial Neoplasia: Terminology, diagnosis and ancillary studies. Adv Anat Pathol. 2017; 24: 136. doi: 10.1097/PAP.0000000000000149.

  7. Faber MT, et al. Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva. Int J cáncer.2017; 141: 1161. doi: 10.1002/ijc.30821

  8. Dodds A, Chia A, Shumack S. Actinic keratosis: rationale and management. Dermatol Ther (Heidelb). 2014 Jun; 4 (1): 11-31. doi: 10.1007/s13555-014-0049-y.

  9. Del Rosso JQ, et al. Comprehensive management of actinic keratoses. Practical integration of available therapies with a review of a newer treatment approach. J Clin Aesthet Dermatol. 2014; 7 (9 Suppl S2-S12): S2-S12.

  10. Valari O, et al. Human papillomavirus DNA and mRNA positivity of the anal canal in women with lower genital tract HPV lesions: predictors and clinical implications. Gynecol Oncol. 2011; 122 (3): 505-8. doi: 10.1016/j.ygyno. 2011.05.033

  11. Wiley D, et al. Human papillomavirus: the burden of infection. Obstet Gynecol Surv. 2006 Jun; 61 (6 Suppl 1): S3-14. doi: 10.1097/01.ogx.0000221010.82943.8c

  12. Aggarwal C, et al. Immunotherapy targeting HPV 16/18 generates potent immune responses in HPV-Associated Head and Neck Cancer. Clin Cancer Res. 2019; 25 (1): 110- 24. doi: 10.1158/1078-0432.CCR-18-1763.

  13. Uzcátegui YB, Tovar MC, Lorenzo CJ, González M. Patología vaginal: utilidad de la citología y la colposcopia como métodos diagnósticos. Rev Obstet Ginecol Venez 2012;72(3):161-170.

  14. Williamson BA, et al. Significance of extensive hyperkeratosis on cervical/vaginal smears. Acta Cytol. 2003; 47 (5): 749-52. doi:10.1159/000326600

  15. Jamison JH, et al. Spectrum of genital human papillomavirus infection in a female adolescent population. Sex Transm Dis. 1995; 22 (4): 236-43.




2020     |     www.medigraphic.com