Buschke-Lowenstein Tumor

Abstract

An 18-year-old man with a history of Human Immunodeficiency Virus infection presented to our clinic with a perianal mass. He was recently diagnosed with Human Immunodeficiency Virus and had never been on antiretroviral therapy. Physical examination revealed a foul-smelling 25 × 15 cm verrucous cauliflower-like ulcerated mass originating from the perianal skin (Figure 1). Wide surgical excision was performed. Histologic examination revealed squamous epithelial verrucous proliferation with marked papillomatosis and acanthosis. Tumor cells exhibited vacuolized cytoplasm with irregular and large nuclei consistent with koilocytes. No atypia or dysplasia was found at the histologic examination. These findings were consistent with a giant condyloma acuminata also known as Buschke-Lowenstein tumor. Adjuvant treatment with topical imiquimod was started with no evidence of recurrence at 6-month follow-up.