title: Invasive squamous cell carcinoma arising in refractory perianal Bowen's disease in a HIV-positive individual.
abstract: A 54-year-old HIV-positive homosexual man presented with erythematous and pigmented plaques on background erythema in the perianal region, histologically consistent with Bowen's disease. Perianal Bowen's disease represents high-grade anal intraepithelial neoplasia, which is considered a precursor lesion of invasive anal squamous cell carcinoma. This patient's anal intraepithelial neoplasia was unresponsive to multiple treatment modalities including cryotherapy, serial curettage and cautery, topical 5-fluorouracil and 5-aminolaevulinic acid photodynamic therapy. He progressed to develop a poorly differentiated squamous cell carcinoma of the anus three and a half years after the Bowen's disease was diagnosed. The squamous cell carcinoma was treated with combined chemoradiation. A recurrence of high-grade anal intraepithelial neoplasia was noted 6 months after completion of chemoradiation.
authors.affiliation: Skin and Cancer Foundation, University of Sydney at Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. asokaherat@hotmail.com
authors.forename: Asoka
authors.initials: A
authors.lastname: Herat
authors.forename: Kyoko
authors.initials: K
authors.lastname: Shirato
authors.forename: Diona L
authors.initials: DL
authors.lastname: Damian
authors.forename: Robert
authors.initials: R
authors.lastname: Finlayson
authors.forename: Margot
authors.initials: M
authors.lastname: Whitfeld
mesh_terms: D001003:Anal Canal; D001913:Bowen's Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D015658:HIV Infections; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012878:Skin Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy