Abstract

A 42-year-old woman presented with an asymptomatic lesion of nearly 6-months duration on the right surface of the anal canal mucosa. She had an 18-year history of HIV infection on triple antiretroviral therapy. Her CD4 count was 420 cells/mm 3 and viral load was undetectable. As a remarkable antecedent, 6 years ago, she underwent a conization because of a high-grade intraepithelial cervical neoplasia (CIN) and a partial vulvectomy because of an intraepithelial vulval neoplasia (VIN), both related to an HPV 16 infection. Physical examination showed a 3- 2-cm tumor proximal to the right side of the anal verge. Microscopic evaluation of a lesional biopsy led to the diagnosis of squamous cell carcinoma of the anal canal. HPV 16 was detected again by PCR on the tissue sample. The incidence of anal cancer is increasing among several important subgroups of the population, in particular among people with HIV. In a recent study, the incidence rate of anal cancer in an HIV-infected cohort reached 128/100,000 person-years during 2006-2008[1].The incidence of anal cancer is greatest in men who have sex with men (MSM) with reported rates of 70-224/100,000 population Among women with HIV, the incidence of invasive anal cancer is 7-28 times higher than in the general population, most of them being squamous cell carcinomas