Vulval cancer in a breast cancer survivor: Can Human Papilloma Virus (HPV) be a connecting link?

Archana Bharti; Dr Ajay Chhikara; M H Mankad; P S Dave; A S Chauhan

Volume : V, Issue : VI, June - 2016

Vulval cancer in a breast cancer survivor: Can Human Papilloma Virus (HPV) be a connecting link?

Archana Bharti, Dr Ajay Chhikara, M H Mankad, P S Dave, A S Chauhan

Abstract :

 Introduction: The majority of molecular mechanisms in the genesis of east cancer are not known. There is growing evidence to support the possible role of HPV in the development of east cancer. On the other hand, the causal relationship of HPV to vulval cancer is well established. We hereby report a case of vulval cancer in a east cancer survivor and propose that HPV might be the connecting link. Case report: A 73 years old postmenopausal woman, a known case of east cancer was referred to our Gynecological Oncology Department in August 2013 after excisional biopsy of her 1x1cm sized vulval lesion by her primary gynaecologist. Histopathology revealed high grade squamous cell carcinoma. She reported history of east cancer two years back for which she underwent modified radical mastectomy with axillary lymph node dissection in Oct 2011. Histopathology showed intraductal carcinoma. She was staged as T2 N1 M0 and received adjuvant chemotherapy till March 2012. Mammo–sonography of her opposite east done at that time showed two punctuate calcification in retroalveolar region which on Fine Needle Aspiration Cytology, revealed intraductal papilloma. She also reported history of total abdominal hysterectomy with bilateral salpingo–oophorectomy in September 2012 for an adenexal mass which was of benign histology. After work up, radical vulvectomy and bilateral groin dissection was done. Histopathology revealed squamous cell carcinoma in situ in 1.5 cm lesion around excisional biopsy (squamous cell carcinoma) site. She was staged as T1N0M0 cancer vulva and kept on observation. On two years of follow up, patient was alive and disease free. Conclusion: HPV might be linked to vulval cancer development in the east cancer survivor. Breast cancer survivors should undergo screening for premalignant cervical and vulval lesions during their follow up