HPV 16 infection in a patient with two primary squamous cell carcinomas: Of the uterine cervix and the anal mucosa

A 43-year-old woman presented with metrorrhagia and a polypoid anal tumor. Cervical dilatation and endocervical curettage and resection of the anal tumor revealed two primary squamous cell carcinomas: of the uterine cervix and the anal mucosa. HPV 16 was identified in both tumors using an in situ hybridization technique with probes against HPV 6, 11, 16, 18, 31 and 33. The cervical carcinoma was weakly positive for p53 protein, whereas the anal tumor was p53 protein negative. Five years later a recurrence of the cervical carcinoma was diagnosed and a hysterectomy was performed. Of 3,013 patients with squamous cell carcinoma of either the cervix or the anus registered in our files, only one had a primary carcinoma in both locations. It was concluded hat HPV 16-induced squamous cell carcinoma may occur simultaneously in the cervix and the anus, and carcinoma in either of the two locations has to be ruled out when dealing with HPV infection in the anogenital tract.