Warty carcinoma of the uterine cervix: a virus-induced disease?
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Department of Gynaecological Oncology, Medical University Pleven, Pleven, Bulgaria
Department of General and Clinical Pathology, Medical University Pleven, Pleven, Bulgaria
Scientific Laboratory, Department of Epidemiology, Medical University Pleven, Pleven, Bulgaria
Department of Gynaecology, Medical University Varna, Varna, Bulgaria
Department of Plastic and Reconstructive Surgery, MU-Pleven, Pleven, Bulgaria
Complex Oncological Centre Burgas, Burgas, Bulgaria
Submission date: 2020-05-20
Final revision date: 2020-06-15
Acceptance date: 2020-07-04
Online publication date: 2020-08-06
Arch Med Sci 2022;18(5)
Warty carcinoma (WC) of the uterine cervix is a rare subtype of squamous-cell carcinoma (SCC), and its frequency, clinical behaviour, and aetiology are obscure. It originates from condylomas, and a viral carcinogenesis seems logical.

Material and methods:
Retrospective analysis was performed of all cervical carcinomas (CC), diagnosed at a single institution for a 10-year period. Analysed patients had stage I carcinoma. Patients with WC were identified, and their tumour samples were tested for high-risk HPV (hr-HPV) and EBV, using PCR and ISH. Clinical characteristics and WC rates across all stage I CC patients were assessed. All patients had minimum 3-year follow-up, and overall survival (OS) and 5-year survival rates were calculated.

WC comprised 2.2% of all stage I CC (n = 630). The mean age of the patients was 48 years (range: 29–72). The primary tumour size was 2 cm in 4 (28.6%) patients, 2–4 cm in 2 (14.3%) patients, and 4 cm in 8 (57.1%) patients. Lymph node metastasis was found in 1 (7.1%) patient. EBV or hr-HPV were detected in 2 (18.2%) patients using ISH, with no coinfection reported. Hr-HPV was detected in 2 (18.2%) patients; EBV in 4 (36.4%) cases, and in 2 of them (18.2%) there was a co-infection. Thirteen patients had a follow-up of ≥ 5 years and their 5-year OS was 100%.

WC is a rare subtype of SCC with good prognosis, regardless of viral status. In contrast to SCC, its aetiology is not related to hr-HPV. The role of EBV remains unclear and cannot currently be denied.