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Human Papillomavirus Detection and Genotyping on Pelvic Nodes in Patients With Synchronous Gynecological Malignancies: A Tool for Identifying the Primary Site of Lymphatic Spread?
  1. Gianluca Paccagnella, MD*,
  2. Francesca Ruggio, MD*,
  3. Salvatore Gizzo, MD and
  4. Giovanni Battista Nardelli, MD, PhD
  1. * From the Department of Gynecological Sciences and Human Reproduction, Padua University, Padua; and
  2. Department of Gynecological and Obstetrical Sciences and Neonatology, Parma University, Parma, Italy.
  1. Address correspondence and reprint requests to Gianluca Paccagnella, MD, via Giustiniani 3, 35100 Padua, Italy. E-mail: gl.paccagnella{at}


Introduction: Synchronous gynecological tumors are uncommon. Identifying the primary site of lymphatic spread may be difficult.

Methods: Two women with synchronous squamous cervical and adenosquamous endometrial cancers (patient A) and squamous cervical and serous borderline ovarian tumors (patient B) entered retrospectively this study. Both patients had pelvic nodal metastases of unknown origin. Uterine cervix, endometrium, and lymph nodes were tested for human papillomavirus DNA using high-sensitive polymerase chain reaction, followed by oligonucleotide microarray for genotyping.

Results: Human papillomavirus 16 DNA was extracted from portio vaginalis and pelvic nodes of both women. Viral homology between cervical and lymph nodal lesions helped to identify the primary metastasizing tumors in both patients.

Conclusions: Human papillomavirus testing on pelvic lymphatic tissue represents a feasible tool to detect the primary site of lymphatic spread in synchronous gynecological malignancies, when uterine cervix is involved.

  • Synchronous gynecological tumors
  • HPV testing and genotyping
  • Pelvic node metastases
  • Primary metastasizing site

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  • The authors have no conflicts of interest to declare.