Condylomata acuminata and their possible relation to cancer of the uterine cervix. Case report and geographic observations.

A unique case is described of a 21-year-old female with gonorrhea, condylomata acuminata of the vulva and the uterine cervix, a squamous-cell papilloma and precancerous changes in the cervix. In the observed lesion, a very gradual transition was seen from benign areas, displaying marked cytoplasmic vacuolization, to moderately dysplastic areas, with only slight vacuolization. Giant squamous cells with centrally located vesicular or hyperchromatic nuclei were a prominent feature of both the condylomatous and premalignant portions of the lesion. A geographic correlation was observed in the 18 districts of Uganda between the incidence of vulvar and vaginal condylomata acuminata and cervical cancer; the finding may include cervical warts since vulvovaginal changes often extend to the cervix uteri. In addition to the common flat condyloma, the acuminate variant may be a precursor of cervical cancer and progress to malignancy through the stage of a squamous-cell papilloma.