Anal warts degenerate. Report of 13 cases

Genital warts are benign viral epithelial proliferations, verruciformis of ano-genital folds. Their most feared complication is degeneration. The aim of our study was to analyze the epidemiological data, the clinical, paraclinical and therapeutic aspects of degenerate anal warts in the light of our 13 observations, collected over 12 years and to review of the literature. The mean age was 50 years, with a male predominance (9 men and 4 women). The clinical signs are a swelling anal, rectal bleeding and an impaired general condition. Proctologic examination revealed a cauliflowerlike appearance with ulcerative budding in 12 patients and a large perianal ulceration in a patient. Biopsy confirmed the diagnosis in 13 cases with squamous cell carcinoma. Staging showed a pelvic invasion in 2 cases. Serology for immunodeficiency virus (HIV) was negative for all patients. The treatment consisted of abdominoperineal resection with radiotherapy (RTH) in 11 patients, RTH in 2 patients. Warts of the anus are related to human papillomavirus (HPV). Their malignancy is closely linked with certain types of cancer viruses.