Detection of HPV RNA molecules in stratified mucin-producing intraepithelial lesion (SMILE) with concurrent cervical intraepithelial lesion: a case report

Shiho Fukui,Takuya Ayabe,Haruko Hiraike,Yuko Sasajima,Shunsuke Nakagawa,Ranka Kanda,Takeru Sugihara,Takayuki Ichinose,Kazunori Nagasaka,Naoko Iimura

doi:10.1186/s12985-019-1180-2

Abstract

BackgroundStratified mucin-producing intraepithelial lesion (SMILE) is a rare precursor lesion in the uterine cervix that is considered a variant of adenocarcinoma in situ (AIS). Although human papillomavirus (HPV) is thought to be related to the development of SMILE, there is little information available on the detection of HPV integrated into the lesion.Case presentationA 30-year-old female underwent a routine uterine cervical cancer screening, and her Pap smear indicated the possible existence of atypical glandular cells. A cervical biopsy with endocervical curettage was performed. The histopathological analysis showed that she had SMILE and high-grade squamous intraepithelial lesion (HSIL) on her cervix. The lesion was found to be positive for HPV genotypes 52 and 68 by multiplex PCR. In situ hybridization with HPV RNA probes revealed that these HPV types were involved in the onset of HSIL and SMILE, respectively.ConclusionsRare, high-risk HPV genotypes may contribute to the development of SMILE, and their detection can be useful for preventing the progression to carcinoma and ensuring adequate patient management.

Highlights

Stratified mucin-producing intraepithelial lesion (SMILE) is a rare precursor lesion in the uterine cervix that is considered a variant of adenocarcinoma in situ (AIS)
Rare, high-risk human papillomavirus (HPV) genotypes may contribute to the development of SMILE, and their detection can be useful for preventing the progression to carcinoma and ensuring adequate patient management
Most oncogenic or highrisk HPV types associated with invasive cervical cancer are phylogenetically clustered within the species groups Alphapapillomavirus 9 (Alpha-9: HPV16 along with HPV31, 33, 35, 52, and 58) or Alphapapillomavirus 7 (Alpha-7: HPV18 along with HPV39, 45, 59, and 68) [18]

Summary

Conclusions

High-risk HPV genotypes may contribute to the development of SMILE, and their detection can be useful for preventing the progression to carcinoma and ensuring adequate patient management.

Background

Discussion and conclusions