Multiple Primary Malignancies And Human Papilloma Virus Infections

Patients may develop multiple primary malignancies (MPM) due to the occurrence of many known predisposing factors (i.e. genetic background, environmental factors, hormonal unbalance, and acquired immunosuppression); however, in most cases, no obvious cause of has been found [1–3]. During the last few decades, accumulating evidence has pointed to the involvement of human papillomavirus (HPV) in the development of several neoplastic and preneoplastic lesions of anatomic sites beyond the uterine cervix. In particular, HPV has been associated with squamous cell carcinomas and related precursors in the oral cavity, esophagus, skin, larynx, conjunctiva, paranasal sinuses and bronchus, but even in non-Malpighian-derived tumors, such as urinary bladder carcinoma. At least for a subset of these cases, it has been suggested that exposure to HPV can precede the appearance of cancer by 10 or more years [4, 5]; nonetheless, the true prevalence of HPV DNA in pre-cancerous lesions remains uncertain.