tacrolimus and Penile-Neoplasms

Transplant recipients have elevated cancer risk including risk of human papillomavirus (HPV)-associated cancers of the cervix, anus, penis, vagina, vulva and oropharynx. We examined the incidence of HPV-related cancers in 187 649 US recipients in the Transplant Cancer Match Study. Standardized incidence ratios (SIRs) compared incidence rates to the general population, and incidence rate ratios (IRRs) compared rates across transplant subgroups. We observed elevated incidence of HPV-related cancers (SIRs: in situ 3.3-20.3, invasive 2.2-7.3), except for invasive cervical cancer (SIR 1.0). Incidence increased with time since transplant for vulvar, anal and penile cancers (IRRs 2.1-4.6 for 5+ vs. <2 years). Immunophenotype, characterized by decreased incidence with HLA DRB1:13 and increased incidence with B:44, contributed to susceptibility at several sites. Use of specific immunosuppressive medications was variably associated with incidence; for example, tacrolimus, was associated with reduced incidence for some anogenital cancers (IRRs 0.4-0.7) but increased incidence of oropharyngeal cancer (IRR 2.1). Thus, specific features associated with recipient characteristics, transplanted organs and medications are associated with incidence of HPV-related cancers after transplant. The absence of increased incidence of invasive cervical cancer highlights the success of cervical screening in this population and suggests a need for screening for other HPV-related cancers.

Topics: Adolescent; Adult; Anus Neoplasms; Cohort Studies; Female; Humans; Immunosuppression Therapy; Incidence; Male; Middle Aged; Organ Transplantation; Oropharyngeal Neoplasms; Papillomavirus Infections; Penile Neoplasms; Registries; Tacrolimus; United States; Uterine Cervical Neoplasms; Vulvar Neoplasms; Young Adult

Erythroplasia of Queyrat of the glans penis developed in a 79-year-old uncircumcised man on a background of biopsy proven Zoon's plasma cell balanitis affecting the same site on the glans. The Zoon's plasma cell balanitis had been treated with topical pimecrolimus for 1 month prior to the development of clinically evident erythroplasia of Queyrat. He was subsequently treated with topical 5-fluorouracil 5% for 2 weeks, which resulted in clinical clearance. He has since been circumcised.

Topics: Aged; Balanitis; Carcinoma in Situ; Carcinoma, Squamous Cell; Circumcision, Male; Erythroplasia; Humans; Immunosuppressive Agents; Male; Penile Neoplasms; Penis; Plasma Cells; Tacrolimus

Topics: Administration, Topical; Carcinoma, Squamous Cell; Circumcision, Male; Humans; Immunosuppressive Agents; Lichen Sclerosus et Atrophicus; Male; Male Urogenital Diseases; Penile Neoplasms; Tacrolimus

Topics: Balanitis; Carcinoma, Squamous Cell; Humans; Immunosuppressive Agents; Male; Middle Aged; Penile Neoplasms; Tacrolimus