title: Implication of human papillomavirus-66 in vulvar carcinoma: a case report.
abstract: BACKGROUND
  Vulvar cancer in older women is seldom associated with human papillomavirus infection.
  
  
  METHODS
  We present the case of an 80-year-old Greek Caucasian woman with an undetermined obstetric and gynecologic history. The patient underwent radical vulvectomy and bilateral inguinal lymphadenectomy for a vulvar carcinoma. A human papillomavirus infection was suggested on the basis of histological and cytological examinations followed by human papillomavirus DNA typing, which revealed the presence of human papillomavirus-66.
  
  
  CONCLUSIONS
  Even though human papillomavirus-16 and human papillomavirus-18 are most frequently implicated in the pathogenesis of vulvar carcinoma, human papillomavirus-66 can also be regarded as a causative factor. Suspicious lesions should be biopsied, and in the presence of carcinoma, vulvectomy with bilateral lymphadenectomy, if necessary, must be performed. Furthermore, polymerase chain reaction assay analysis with clinical arrays in cytological samples is an accurate test for the detection of a wide range of human papillomavirus genotypes and can be used to verify the infection and specify the human papillomavirus type implicated.
authors.affiliation: Gynecological Oncology Department, "Theagenio" Cancer Hospital, 2 Alex, Simeonidis Street, Thessaloniki, 54007, Greece. ykotsopoulos@yahoo.gr.
authors.forename: Ioannis C
authors.initials: IC
authors.lastname: Kotsopoulos
authors.forename: Georgios P
authors.initials: GP
authors.lastname: Tampakoudis
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Evaggelinos
authors.forename: Anastasia I
authors.initials: AI
authors.lastname: Nikolaidou
authors.forename: Panagiota A
authors.initials: PA
authors.lastname: Fytili
authors.forename: Vasilios C
authors.initials: VC
authors.lastname: Kartsiounis
authors.forename: Domniki K
authors.initials: DK
authors.lastname: Gerasimidou