case report

Giant Condyloma Acuminatum Covering the Vulva, Edges of the Labia Minora and Majora and Anus was Successfully Eliminated with MVA E2 Recombinant Virus Therapeutic Vaccination

Hilda Mar Salas1, Ricardo Rosales2*

1Department of Obstetrics and Gynecology, Centro medico San Patricio, Linares, Nuevo León, México

2Department of Molecular Biology, Virolab, S de RL de CV, Cuernavaca, Morelos, México

* Corresponding author: Ricardo Rosales, Department of Molecular Biology, Virolab, S de RL de CV, Cuernavaca, Morelos, México.

Received Date: 14 December 2022

Accepted Date: 17 December 2022

Published Date: 22 December 2022

Citation: Salas HM, Rosales R (2022) Giant Condyloma Acuminatum Covering the Vulva, Edges of the Labia Minora and Majora and Anus was Successfully Eliminated with MVA E2 Recombinant Virus Therapeutic Vaccination. Ann Case Report. 7: 1097. DOI: https://doi.org/10.29011/2574-7754.101097

Abstract

In this report, we present a case of a large condylomata acuminata lesion in an adolescent 14-year-old female. The condyloma was injected directly with 107 MVA E2 virus particles once a week for an 8-week period. The lesion was monitored by colposcopy every week with the application of acetic acid. The patient was positive for serum antibodies against Human Papillomavirus 11 (HPV 11). Complete regression of the lesion was observed after treatment. No apparent side effects or recurrences were observed at one year of follow-up. This case report suggests that therapeutic vaccination with MVA E2 is an excellent option to achieve regression of anogenital papilloma lesions.

Keywords: Condyloma; MVA Strain; Papillomavirus; Vaccinia Virus

Introduction

Human papillomavirus produces benign lesions, named papillomas [1,2].These small, wart-like neoplasias are present in the anogenital mucosa and skin and in very rare cases invade the vulva and vagina [3,4]. However, in some cases, papillomas can become large condyloma lesions, destroying the epithelium. Additionally, vulvar HPV infection can lead to the development of benign tumors (condylomata acuminata) [5]. Probably because of the weak immune response against the papillomavirus-infected cells. The most common viruses found in this type of lesion are HPV 6 and HPV 11 [1]. And HPV 11 is found in one-fourth of genital warts. [5,6] Furthermore, the rate at which lesions grow may depend on the genetic constitution of the patients as well as the possible HPV variant involved. Standard procedures, such as cryotherapy, trichloroacetic acid, and laser or surgical removal, provide very good treatment for these lesions [7]. Nonetheless, recurrences and reinfections occur because these procedures are not able to eliminate the HPV [8,9]. In addition, it is well known that HPV can inhibit the recognition of malignant cells by the immune system, leading to the development of lesions [10-16]. Recently, we described the therapeutic approach involving the recombinant vaccinia virus strain MVA E2 to treat many types of lesions generated by papillomaviruses [17-23]. Here, we present one of the few cases of a giant condyloma covering the anogenital tract and its complete elimination by treatment with the MVA E2 therapeutic vaccine.

Case Report

A 14-year-old female was admitted to the Medical CenterSan Patricio with a Giant Condyloma Acuminatum (GCA) lesion in the vulva and perianal area. According to the clinical history, the  patient had only one sexual partner. Macroscopic examination of the lesion revealed a length of 8 cm, width of 5 cm and thickness of 0.5 mm (Figure 1). The lesion grew over approximately 6 months and did not interfere with defecation; no bleeding was observed. A biopsy sample was not taken because of the high degree of pain presented by the patient. The presence of high levels of antibodies against HPV 11 was detected in her serum [24]. The patient did not present other infectious diseases that may have contributed to the generation of the giant condyloma. The lesion was treated by injecting 107 virus particles of the MVA E2 therapeutic vaccine inside the lesion and in the basal epithelium of the lesion once a week for an 8-week period. One month later, tiny spots of the remaining condyloma were eliminated with the application of Trichloro Acetic Acid (TCA).