Cancer Res Treat.  2015 Oct;47(4):954-957. 10.4143/crt.2014.111.

HPV-Related Retroperitoneal Squamous Cell Carcinoma of Unknown Primary: A Case Report

Affiliations
  • 1Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea. drjin@catholic.ac.kr
  • 2Department of Obstetrics and Gynecology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
  • 3Department of Hospital Pathology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

Abstract

A 56-year-old female was referred to our hospital due to a mass measuring 5 cm in size in the left pelvic cavity, which was found incidentally during a health examination by ultrasonography. Exploratory laparotomy was performed and the mass was located at the left retroperitoneal parametrium without invasion of the uterus and ovary. The pathology report confirmed squamous cell carcinoma. Even after further studies, we did not find any other primary lesion. Human papillomavirus (HPV) DNA chip test (HPV 9G DNA Membrane Kit, Biometrixtechnology Inc.) showed that the surgical specimen was positive for HPV 18. She received adjuvant chemotherapy and would receive radiation therapy for the possibility of occult gynecologic cancer. Retroperitoneal squamous cell carcinoma of unknown primary is extremely rare and little is known about it. It is reported that HPV may be associated with the disease. Hence, the result of HPV test could have an impact on finding a suspicious primary lesion and treatment modality in this case.

Keyword

Retroperitoneal neoplasms; Squamous cell carcinoma; Human papillomavirus

MeSH Terms

Carcinoma, Squamous Cell*
Chemotherapy, Adjuvant
DNA
Female
Human papillomavirus 18
Humans
Laparotomy
Membranes
Middle Aged
Oligonucleotide Array Sequence Analysis
Ovary
Pathology
Retroperitoneal Neoplasms
Ultrasonography
Uterus
DNA

Figure

  • Fig. 1. (A) Transvaginal ultrasound demonstrated a left pelvic mass with complex echogenicity of 5.18 cm×3.68 cm. (B) T2 weighted pelvic magnetic resonance imaging showed a solid and cystic, heterogeneous enhanced mass measuring 5.5 cm in size in the left pelvic cavity.

  • Fig. 2. (A) Microscopic examination shows a well capsulated retroperitoneal mass (H&E staining, ×40). (B) Microscopic examination shows poorly differentiated squamous cell carcinoma (H&E staining, ×400). (C) Immunohistochemical staining of p63 shows strong nuclear positivity (×200).


Reference

References

1. Ryu MJ, Chung YW, Bae HS, Lee JK, Lee NW, Song JY. Primary squamous cell carcinoma arising from the pelvic retroperitoneum. Korean J Obstet Gynecol. 2012; 55:782–6.
Article
2. Hofmann U, O'Connor JP, Biyani CS, Harnden P, Selby P, Weston PM. Retroperitoneal metastatic squamous cell carcinoma of the tonsil (with elevated beta human chorionic gonadotrophin): a misdiagnosis as extra-gonadal germ cell tumour. J Laryngol Otol. 2006; 120:885–7.
Article
3. Munoz N, Castellsague X, de Gonzalez AB, Gissmann L. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006; 24 Suppl 3:S3:1–10.
Article
4. Staebler A, Sherman ME, Zaino RJ, Ronnett BM. Hormone receptor immunohistochemistry and human papillomavirus in situ hybridization are useful for distinguishing endocervical and endometrial adenocarcinomas. Am J Surg Pathol. 2002; 26:998–1006.
Article
5. Clements A, Euscher E, Lacour R, Merritt W, Klopp A, Ramondetta L. The presence of human papillomavirus or p16 in six cases of retroperitoneal carcinoma. Obstet Gynecol. 2010; 116:1042–6.
Article
6. Capone RB, Pai SI, Koch WM, Gillison ML, Danish HN, Westra WH, et al. Detection and quantitation of human papillomavirus (HPV) DNA in the sera of patients with HPVassociated head and neck squamous cell carcinoma. Clin Cancer Res. 2000; 6:4171–5.
7. Kan CY, Iacopetta BJ, Lawson JS, Whitaker NJ. Identification of human papillomavirus DNA gene sequences in human breast cancer. Br J Cancer. 2005; 93:946–8.
Article
8. Chen CH, Yeh SD, Chiou JF, Lin YH, Chang CW. Optimum treatment for primary squamous cell carcinoma of the pelvic retroperitoneum. J Exp Clin Med. 2011; 3:304–6.
Article
9. Boneschi M, Erba M, Cusmai F, Eusebio D, Miani S, Bortolani EM. Primary retroperitoneal tumors: treatment modality and prognostic factors. Minerva Chir. 1999; 54:763–8.
10. Carabias E, Garcia Munoz H, Dihmes FP, Lopez Pino MA, Ballestin C. Primary mucinous cystadenocarcinoma of the retroperitoneum. Report of a case and literature review. Virchows Arch. 1995; 426:641–5.
11. Dore R, La Fianza A, Storti L, Babilonti L, Preda L, Di Maggio EM, et al. Primitive mucinous cystadenocarcinoma of the retroperitoneum: case report and diagnostic considerations. Clin Imaging. 1996; 20:129–32.
Article
12. Caruncho M, Pombo F, Arnal-Monreal F. Primary retroperitoneal serous cystadenocarcinoma of 'ovarian-type': US and CT findings. Eur J Radiol. 1993; 17:115–6.
Article
13. Ramshankar V, Krishnamurthy A. Human papilloma virus in head and neck cancers-role and relevance in clinical management. Indian J Surg Oncol. 2013; 4:59–66.
Article
14. Zandberg DP, Bhargava R, Badin S, Cullen KJ. The role of human papillomavirus in nongenital cancers. CA Cancer J Clin. 2013; 63:57–81.
Article
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