Detection of Human Papillomavirus Type 16 in Bowenoid Papulosis and Invasive Carcinoma Occurring in the Same Patient With a History of Cervical Carcinoma

To the Editor.—  Human papillomavirus (HPV) type 16 (HPV-16) has been found in lesions of bowenoid papulosis, Bowen's disease, and cervical intraepithelial neoplasia, as well as anogenital carcinoma. Although bowenoid papulosis is well known to occur in patients who had been treated for cervical carcinoma,¹ the progression of bowenoid papules themselves to invasive carcinoma is not well documented. In the present report we describe a woman with a previous history of treated carcinoma of the cervix who developed invasive carcinoma of Bowen's type, apparently arising from bowenoid papulosis on her perianal region, and regional lymph node metastasis; in both lesions of the invasive carcinoma and of bowenoid papulosis we found the presence of HPV-16 DNA. This case presents strong evidence for a causal relationship between HPV-16 and cancer derived from its precursor lesion.

Report of a Case.—  A 56-year-old woman was first seen by us in May 1986, with a complaint of a nodule of ten months' duration on the left side of her perianal