PERIANAL SQUAMOUS CELL CARCINOMA WITH HIGH-GRADE ANAL INTRAEPITHELIAL NEOPLASIA IN AN HIV-NEGATIVE PATIENT

HPV infection and associated diseases in the male population has assumed importance, especially because of the increase in incidence of anal carcinoma. The recognition that man is no longer mere infection vector for this disease is still poorly discussed, and can result in diagnostic losses and further increase in anogenital disease morbidity. In this study, we aimed to present a case of an atypical anogenital lesion caused by HPV infection in a HIV(-) male patient. Clinical exam showed perianal lesion. This lesion has been misdiagnosed and treated as herpes and candidiasis for almost ten years, when ulceration was observed, followed by purulent secretion. Histopathology showed intraepithelial neoplasia constituted by atypical keratinocytes, loss of polarity and corneal pearls compatible with Bowen’s disease. Specific PCR showed HPV 16 DNA in both episomal and integrated forms. Successful treatment was achieved by radiotherapy. The knowledge about the behavior of anogenital HPV infection in men is still unclear, even for high-risk groups such as MSM (men who have sex with men) and HIV seropositive. Therefore, several patients have been maintained without diagnosis, being regarded as sources of infection and even suffering from high-grade lesions with clinical unsatisfactory outcomes. Our goal with this case report is to contribute to the dissemination of an emerging problem, stimulating discussion and the search for new tools of early recognition and treatment of male anogenital lesions. DOI:  http://dx.doi.org/10.17525/vrr.v18i1-2.64