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Recurrent Condylomata Acuminata in a Transplant Patient

  • Ritchie Delara , Longwen Chen , Tonia Young-Fadok and Megan Wasson
Published/Copyright: October 1, 2020
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 120 Issue 10

A 49-year-old woman presented with recurrent vulvar and perianal condyloma for 1 year (image A). Her medical history included deceased donor renal transplant. She was taking 500 mg of mycophenolate orally twice per day and 2 mg of tracrolimus orally twice per day for immunosuppressive therapy. She had prior wide local excision of bilateral vulva with laser fulguration of a condyloma and subsequent trichloroacetic acid ablation. An anal Papanicolaou test was positive for low-grade squamous intraepithelial lesion (image B). Vulvar and anorectal condyloma excision was performed (image C and image D). Vulvar condylomas were negative for dysplasia and high-risk human papillomavirus. Perianal condylomas were positive for squamous cell carcinoma in situ and positive for (other high-risk) human papillomavirus (image E).

Women who are immunosuppressed and aged 40 years or older with a history of vulvar or cervical dysplasia have an increased risk for anogenital cancer.1-5 Abnormal cytologic findings should prompt high-resolution anoscopy or referral to colorectal surgery.1,3 When managing benign conditions like vulvar condylomas, gynecologists should strongly consider anal cancer screening using history, examination, and anal cytology with cotesting.

From the Department of Gynecologic Surgery (Drs Delara and Wassoon); the Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology (Dr Chen); and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Young-Fadok) at the Mayo Clinic in Phoenix, Arizona.
Financial Disclosures: None reported.
Support: None reported.

*Address correspondence to Ritchie Delara, MD, 5777 E Mayo Blvd, Phoenix, AZ 85054. Email:

References

1. MoscickiAB, DarraghTM, Berry-LawhornJM, et al.. Screening for anal cancer in women. J Low Genit Tract Dis.2015;19(3 suppl 1):S27-542. doi:10.1097.LGT0000000000000117Search in Google Scholar

2. NadhanKS, LarijaniM, AbbottJ, DoyleAM, LinfanteAW, ChungCL. Prevalence and types of genital lesions in organ transplant recipients. JAMA Dermatol.2018;154(3):323-329. doi:10.1001/jamadermatol.2017.5801Search in Google Scholar PubMed PubMed Central

3. StierEA, SebringMC, MendezAE, BaFS, TrimbleDD, ChiaoEY. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review. Am J Obstet Gynecol. 2015;213(3):278-309. doi:10.1016/jajog.2015.03.034.Search in Google Scholar

4. VeguntaS, FilesJA, WassonMN. Screening women at high risk for cervical cancer: special groups of women who require more rrequent screening. Mayo Clin Proc. 2017;92(8):1272-1277. doi:10.1016/j.mayocp.2017.06.007Search in Google Scholar PubMed

5. WorkowskiKA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep. 2015;64(33):924]. 2015;64(RR-03):1-137. MMWR Recomm Rep. 2015;64(RR-03):1-137.Search in Google Scholar

Received: 2020-02-22
Accepted: 2020-02-28
Published Online: 2020-10-01
Published in Print: 2020-10-01

© 2020 American Osteopathic Association

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https://doi.org/10.7556/jaoa.2020.126

Articles in the same Issue

  1. ORIGINAL CONTRIBUTION
  2. Osteopathic Medical Licensing Compliance With the Americans With Disabilities Act of 1990
  3. A Pilot Study of Jugular Compression (Queckenstedt maneuver) for Cranial Movement Perception
  4. CASE REPORT
  5. Diagnosis of Myocardial Infarction in a Patient With Left Bundle Branch Block and Negative Sgarbossa Criteria
  6. REVIEW
  7. Musculoskeletal Conditions in Patients With Diabetes: A Narrative Review
  8. The Role of Musculoskeletal Disorders in Chronic Disease: A Narrative Review
  9. CASE REPORT
  10. Orthotics to Improve Pain in a Patient With Multiple Internal Fixations and Multilevel Thoracic Fusion
  11. ORIGINAL CONTRIBUTION
  12. Ultrasound Shear Wave Elastography to Assess Tissue Mechanical Properties in Somatic Dysfunction: A Feasibility Study
  13. BRIEF REPORT
  14. Osteopathic Manipulative Treatment for a Recognizable Pattern of Somatic Dysfunction Following Laparoscopic Cholecystectomy
  15. CASE REPORT
  16. A Case of Resolved Vincristine-Induced Constipation Following Osteopathic Medicine in a Patient With Infantile Fibrosarcoma
  17. OMT MINUTE
  18. Osteopathic Manipulative Treatment for Inhaled Rib Somatic Dysfunction
  19. BRIEF REPORT
  20. Opioid Use in the Postpartum Period: Are We Prescribing Too Much?
  21. ORIGINAL CONTRIBUTION
  22. Effect of Hydration on Doppler Velocity of Renal Arteries
  23. CLINICAL IMAGE
  24. Recurrent Condylomata Acuminata in a Transplant Patient
  25. LETTER TO THE EDITOR
  26. Value of Tenets of Osteopathic Medicine for Patients During COVID-19 Crisis
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