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Bladder

Bladder tumors - benign

Condyloma accuminatum


Reviewers: Nat Pernick, M.D., PathologyOutlines.com, Inc. (see Reviewers page)
Revised: 27 June 2011, last major update June 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

General
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● HPV related lesion similar to counterparts at other sites

Etiology
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● Caused by HPV, almost always subtypes 6 and 11 and not 16 or 18

Clinical features
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● Rare to only involve the bladder, usually occurs by direct extension from genital lesions
● Also associated with long-standing cystotomy, indwelling catheters, fistulas and immunosuppression
● Usually not associated with squamous cell carcinoma of bladder (Am J Surg Pathol 2007;31:1777, Am J Surg Pathol 2006;30:883)

Case reports
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● Due to HPV 16/18 (Int J STD AIDS 2004;15:836, Am J Surg Pathol 1988;12:205)
● Progressing to poorly differentiated spindle cell carcinoma (Scand J Urol Nephrol 2003;37:512)
● 62 year old man with subsequent warty carcinoma (Int J Surg Pathol 2000;8:253)

Treatment
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● Excision (surgical, chemical, laser, other); may recur, but doesn’t progress to carcinoma

Gross description
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● Smooth, pink-tan, papillary

Gross images
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Extensive bladder involvement

Micro description
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● Resembles condylomas at other sites with papillary fronds lined by hyperplastic and metaplastic squamous epithelium with koilocytosis (perinuclear halos), wrinkled nuclei and binucleated cells
● Variable atypia, but no anaplasia

Micro images
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Condyloma

Positive stains
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● HPV 6, 11; p53

Differential diagnosis
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Squamous papilloma: no koilocytosis, HPV negative; rare, usually affects elderly women, p53 negative (Cancer 2000;88:1679)
Verrucous carcinoma: invasive margins, anaplasia, HPV negative

End of Bladder > Bladder tumors - benign > Condyloma accuminatum


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