A case of esophageal squamous cell intraepithelial neoplasia with positivity for type 16 human papillomavirus successfully treated with radiofrequency ablation.
Esophageal cancer is the eight most common cancer worldwide and the sixth cause of cancer related death with squamous cell carcinoma (SCC) accounting for almost half of all esophageal cancers. Persistent human papilloma virus (HPV) infection has been suspected to play an active role in esophageal carcinogenesis but a clear association has not still been proven and no specific indications or guidelines for possible endoscopic and surgical therapeutic approaches to this clinical scenario are available. We report a case of a 62-year-old woman with histological diagnosis of high-grade intraepithelial squamous neoplasia of distal esophagus associated with cytological modifications resembling cervical HPV infection and with a positive INNO-LiPA assay for genotype 16 HPV. A single session of radiofrequency ablation (RFA) was performed on the dysplastic esophageal area with complete endoscopic eradication as confirmed by the following endoscopic, histologic and microbiologic examinations. Our report might give further strength to the hypothesis of an etiological role of HPV in selected cases of esophageal carcinogenesis and opens a discussion on the possible use of Radio Frequency Ablation as an effective and safe endoscopic treatment for both early squamous cell neoplasia and HPV esophageal colonization.
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Alessandro
A
Repici
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Chiara
C
Genco
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Andrea
A
Anderloni
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Paola
P
Spaggiari
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Rossana
R
Mineri
Rosanna
R
Minieri
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Alessandra
A
Carlino
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Manol
M
Jovani
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Vincenzo
V
Villanacci
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Prateek
P
Sharma
1 Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 2 Department of Gastroenterology, DIBIMIS, University of Palermo, Palermo, Italy ; 3 Department of Pathology, IRCCS Istituto Clinico Humanitas, Milan, Italy ; 4 Department of Laboratory Diagnostics, Pathology Section, Brescia, Italy ; 5 Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, USA.
Alberto
A
Malesci
Esophagus; human papilloma virus (HPV); radiofrequency ablation (RFA); squamous cell neoplasia