Invasive Anal Squamous-Cell Carcinoma in the HIV-Positive Patient: Outcome in the Era of Highly Active Antiretroviral Therapy

Introduction: Squamous cell carcinoma (SCC) is the main cancer of lips; it is increasingly diagnosed in HIV-positive patients. In most cases, there are factors that promote his occurrence. We report a case of an HIV-positive woman with SCC of the lower lip complicating recurrent labial herpes. Medical observation: It was a case of a 40-year-old female received in consultation for a painful and ulcerous lesion of her lip lasting 5 months. She was a HIV-positive patient diagnose since 2007 and on Highly Active Antiretroviral Therapy since that time. She was taking alcohol, was exposed to sunlight regularly, and had presented many episodes of labial herpes in the past. On clinical examination she had a painful ulcero-crustal medallion measuring 2.5 centimeters in diameter, with a papular edge of pearlescent appearance of the lower lip. Given this clinical picture, the diagnosis of chronic decaying herpes labialis with in differential an epithelial tumor (in particular a squamous cell carcinoma of the lower lip) was mentioned. After surgical excision, an anatomopathological analysis of the part confirmed the diagnosis of squamous cell carcinoma. At the time of diagnosis, the patient had a respective CD4 and CD8 level of 939 and 964 cells / mm3 . The evolution was marked 6 weeks later by the scarring with complete epithelialization of the site of the lesion. Conclusion: SCC of the lips is a frequent cancer occurring during HIV infection; there are many risk factors which promote his occurrence. Earlier the treatment is instituted, better is the prognosis.

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Anal Squamous Cell Carcinoma in the HIV-Positive Patient

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0029-1223841 ◽

2009 ◽

Vol 22 (02) ◽

pp. 102-106 ◽

Cited By ~ 8

Author(s):

Deborah Nagle

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Positive Patient ◽

Hiv Positive ◽

Anal Squamous Cell Carcinoma

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Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Diseases of the Colon & Rectum ◽

10.1007/s10350-004-0584-1 ◽

2004 ◽

Vol 47 (8) ◽

pp. 1305-1309 ◽

Cited By ~ 39

Author(s):

Ronney F. Stadler ◽

Sharon G. Gregorcyk ◽

David M. Euhus ◽

Ronald J. Place ◽

Philip J. Huber ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Antiretroviral Therapy ◽

Anal Canal ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Invasive Squamous Cell Carcinoma ◽

Highly Active

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Human Papillomavirus Infection and Its Association with HIV

Advances in Dental Research ◽

10.1177/0022034511399914 ◽

2011 ◽

Vol 23 (1) ◽

pp. 84-89 ◽

Cited By ~ 27

Author(s):

S. Syrjänen

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Antiretroviral Therapy ◽

Cell Carcinoma ◽

Oral Mucosa ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Case Control Studies ◽

Highly Active ◽

Increased Risk

Human papillomavirus (HPV) can infect oral mucosa, causing asymptomatic infection or warty lesions. Several case-control studies have confirmed HPV as an independent risk factor for squamous cell carcinoma. HPV-related cancers seem to have better prognoses and different risk factors than do HPV-negative ones. HIV-infected patients are known to be at increased risk for persistent genital and anal high-risk HPV infections and intraepithelial neoplasm. Since the era of highly active antiretroviral therapy, the prevalence and persistence of warty lesions in oral mucosa have increased. Oral squamous cell carcinoma was recently added in the case definitions for common HIV-related oral mucosa lesions. The increased risk of HPV infection in HIV patients has been associated with impaired immune response to HPV, highly active antiretroviral therapy, aging of the HIV-infected patients, and direct interaction between the 2 viruses. HPV32 seems to be much more prevalent in asymptomatic HPV infections and warts among those infected with HIV than among those in the general population. Regarding HIV genes, there is evidence of an interaction between HPV and tat, rev, and vpr. HIV might play a role in HPV-associated pathogenesis by exhorting oncogenic stimuli via tat and rev or visa versa.

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Anal squamous cell carcinoma in a high HIV prevalence population

Discover Oncology ◽

10.1007/s12672-021-00397-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Danielle R. L. Brogden ◽

Christopher C. Khoo ◽

Christos Kontovounisios ◽

Gianluca Pellino ◽

Irene Chong ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Disease Free Survival ◽

Hiv Positive ◽

Anal Squamous Cell Carcinoma ◽

Free Survival ◽

Persons Living With Hiv ◽

Disease Free ◽

Hiv Negative

AbstractAnal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV (PLWH) diagnosed with ASCC. This is a retrospective cohort study of HIV positive and HIV negative patients diagnosed with primary ASCC between January 2000 and January 2020 in a demographic group with high prevalence rates of HIV. One Hundred and seventy six patients were included, and clinical data was retrieved from multiple, prospective databases. A clinical subgroup was identified in this cohort of younger HIV positive males who were more likely to have had a prior diagnosis of Anal Intraepithelial Neoplasia (AIN). Gender and HIV status had no effect on staging or disease-free survival. PLWH were more likely to develop a recurrence (p < 0.000) but had a longer time to recurrence than HIV negative patients, however this was not statistically significant (46.1 months vs. 17.5 months; p = 0.077). Patients known to have a previous diagnosis of AIN were more likely to have earlier staging and local tumour excision. Five-year Disease-Free Survival was associated with tumour size and the absence of nodal or metastatic disease (p < 0.000).

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Gemella morbillorumisolated from a pelvic abscess in an HIV-positive patient with squamous cell carcinoma of the perianal region

BMJ Case Reports ◽

10.1136/bcr-2018-227352 ◽

2019 ◽

Vol 12 (5) ◽

pp. e227352 ◽

Cited By ~ 1

Author(s):

Benjamin Edward Ueberroth ◽

Renato Roxas

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Pelvic Abscess ◽

Positive Patient ◽

Hiv Positive ◽

Perianal Region ◽

The Past ◽

Initial Improvement ◽

Time Of Admission

Gemella morbillorumis a known commensal organism of the human oropharynx, gastrointestinal tract and genitourinary tract which is a rare cause of infections and even more rarely implicated in skin and soft tissue infections. We present a case of a young, HIV-positive patient with squamous cell carcinoma of the perianal region who presented with difficulty initiating urination for 1 week as well as increasing left leg swelling. His CD4 count was found to be 186, predisposing him to infection, and he had also received chemotherapy in the past year for his malignancy. He was febrile and tachycardic on presentation and admitted for further care. CT scan of the pelvis at time of admission demonstrated a pelvic abscess. Aspiration cultures ultimately grewG. morbillorum.Despite initial improvement with drainage and targeted antimicrobial therapy, the patient’s abscess recurred, and he ultimately elected transition to hospice due to worsening prognosis of malignancy.

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Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.2810 ◽

2008 ◽

Vol 26 (3) ◽

pp. 474-479 ◽

Cited By ~ 83

Author(s):

Elizabeth Y. Chiao ◽

Thomas P. Giordano ◽

Peter Richardson ◽

Hashem B. El-Serag

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Cell Cancer ◽

Cox Proportional Hazards ◽

Administrative Databases ◽

Hiv Positive ◽

Highly Active ◽

Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

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