Squamous Cell Carcinoma Treated with Human Papillomavirus Tetravalent Vaccine

Abstract

We report a case of squamous cell carcinoma (SCC) treated with the quadrivalent human papillomavirus (HPV) vaccine in a 30-year-old woman with long-term immunosuppression. She complained of a growing perianal tumor that had emerged a year before the first visit. Multiple tumors were found in the vulvar, as well as perianal areas. HPV-DNA testing revealed positivity in the lesion. Although the skin biopsy revealed the proliferation of atypical keratinocytes, most of the lesion comprised acanthosis with some infiltrating parts, yielding the definitive diagnosis of HPVassociated SCC. The widespread lesion and enlarged bilateral illio-inguinal lymph nodes hampered wide curative resection because the treatment may cause poor postoperative quality of life. Thus,we proposed chemoradiotherapy as a guideline-based treatment option. However, she was reluctant to undergo chemotherapy because of concerns about side effects such as infertility or alopecia. As intratumoral administration of HPV tetravalent vaccine (Gardasil ^○R ) is reportedly effective at the case report level, we performed intra-lesional vaccination as an alternative. Skin Research, 21 : 194-199, 2022