Human Papillomavirus Type 6 in Grade I Transitional Cell Carcinoma of the Urethra

Abstract

Of 4 patients who underwent cystourethroscopy, biopsy and laser excision of suspected urethral condylomata acuminata 3 had coexistent grade I papillary transitional cell carcinoma of the urethra. Human papillomavirus type 6 messenger ribonucleic acid was demonstrated within biopsy specimens using tritium-labeled single-stranded antisense ribonucleic acid probes. Compared to condylomata the papillary transitional epithelium expressed less viral message, which might be expected in an epithelium that does not show full squamous epithelial or koilocytotic differentiation. Among these patients there was 1 papillary transitional lesion in the bladder that, although histologically similar, did not express human papillomavirus message, suggesting differential susceptibility of epithelium between the bladder and urethra. The finding of active human papillomavirus transcription within the urethral papillary transitional lesions raises the possibility of an active role for the virus in the pathogenesis of these lesions. These findings broaden the spectrum of epithelial types reported to support human papillomaviruses and provides impetus for a wider search for these viruses in other transitional cell neoplasms.

Primary urethral transitional cell carcinoma presenting as a urethral caruncle

“…Theories to explain the occurrence of TCC in the anterior part of urethra include the possibility of either ectopic or metaplastic urothelium. A single previous report has shown an association between human papilloma virus type 6 infection and a primary anterior urethral TCC [3]. \However, no such history was found in this patient.…”

Transitional Cell Carcinoma of the Fossa Navicularis in a Man with Preexisting Adenocarcinoma of the Prostate

“…Numerous processes including foci of ectopic transitional epithelium, metaplasia, and HPV infection have been proposed, and as yet, no evidence points to any one of these hypotheses. Mevorach et al [7] were able to demonstrate HPV type 6 in 3 patients with transitional cell…”

Primary urethral transitional cell carcinoma with scrotal metastases

“…It occurs mostly in the posterior urethra where transitional epithelium continues with that of the bladder, but TCC of the anterior urethra, which is lined by squamous epithelium, is very rare (1). Isolation of human papilloma virus (type 6) RNA in some cases raises the possibility of a viral aetiology (2). There are no previous documented reports of scrotal or dermal metastases of this tumour.…”