Grade 3 vulvar and anal intraepithelial neoplasia in a HIV seropositive child--therapeutic result: case report

A case report of a HIV seropositive 8-year-old child with vulvar and anal border neoplasia, both grade 3, and the adopted therapeutic management are presented. The mother reported the history of a progressively growing verrucous lesion in the vulva since the age of three and a half years. On physica...

Full description

Saved in:
Bibliographic Details
Published in:Clinical and experimental obstetrics & gynecology 2005, Vol.32 (2), p.138-140
Main Authors: de Góis, N M Speck, Costa, R R L, Kesselring, F, de Freitas, V G, Ribalta, J C L, Kobata, M P, Taha, N S
Format: Article
Language:English
Subjects:
Administration, Topical
Aminoquinolines - administration & dosage
Anti-HIV Agents - therapeutic use
Anus Neoplasms - pathology
Anus Neoplasms - therapy
Carcinoma - pathology
Carcinoma - therapy
Child
Combined Modality Therapy
Female
Follow-Up Studies
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - immunology
HIV Seropositivity
Humans
Immunocompromised Host
Low-Level Light Therapy - methods
Papillomavirus Infections - pathology
Papillomavirus Infections - therapy
Risk Assessment
Treatment Outcome
Vulvar Neoplasms - pathology
Vulvar Neoplasms - therapy
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A case report of a HIV seropositive 8-year-old child with vulvar and anal border neoplasia, both grade 3, and the adopted therapeutic management are presented. The mother reported the history of a progressively growing verrucous lesion in the vulva since the age of three and a half years. On physical examination a pigmented and elevated lesion was observed in the whole vulvar region extending to the anal region and intergluteal sulcus. After biopsies and anatomic pathological examination, antiretroviral therapy, adequate for age, and topical application of podophyllotoxin associated with Thuya officinalis extract was started. Three months afterwards vaporization and CO2 laser excision were performed in five sequential sessions, thereafter associated with topical imiquimod application. After the first two sessions of laser therapy early relapses occurred. After four weeks of imiquimod use, already a significant improvement of the lesions was observed, making the following laser therapy sessions easier. We conclude that antiretroviral therapy associated with podophyllotoxin and Thuya was not effective regarding regression of the lesions. Laser therapy alone led to early relapses. The local use of imiquimod associated with laser was effective in decreasing and controling the lesions.
ISSN:0390-6663