Abstract
High-risk Human Papillomavirus (HPV) infections cause squamous intraepithelial lesions which act as precursors to invasive cancers. Due to the integration of HPV into host DNA, patients who have been diagnosed with HPV-associated invasive or preinvasive tumors may have a five-to-ten-fold increased risk of a second HPV-associated cancer, with a particularly strong association between anal and vulvovaginal cancers. This is a case report of a 26-year-old HIV-negative nulliparous female who developed independent squamous cell cancers of the vulvar, vaginal, cervix, and anus within a 2-year time frame in Cameroon. HPV specimens collected from the vagina and anus, and genotyped using the AmpFire HPV analyzer, revealed the presence of HPV Types 33, 51, and 68. Worldwide, HPV types 16 and 18 have been noted as the most virulent HPV types. Neither of these types was present in this patient with aggressive HPV-associated cancers. It is not known if the combination of these three types; 33, 51, and 68 forms a particularly virulent association in this population. This case demonstrates the importance of investigating less common high-risk HPV types and associated pathologies in this population. HPV genotypes other than 16 and 18 may play a significant role in cancer development in this population.
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