Giant Condyloma Acuminatum Research Articles

Verrucous carcinoma of vulva associated with lichen sclerosus and condyloma: case report

Vulvar Verrucous Carcinoma (VVC) is a rare lesion, with few described cases. It has low metastatic potential with high morbidity due to the necessity of extensive resections, although. Previously, VVC was considered a synonym to the Buschke-Lowenstein Tumor (BLT) or Giant Condyloma Acuminatum (GCA). Lichen Sclerosus (LS) is associated with Vulvar Intraepithelial Neoplasia (VIN) and Vulvar Squamous-cell carcinoma (SCC); association with VVC is also described. The case of a 60-year-old menopausal woman is reported; she had chronic itching and an extensive verrucous lesion in vulva, initially diagnosed and treated as condyloma acuminatum; there was recurrence as verrucous carcinoma associated to LS. Excision with margins was performed and clobetasol and imiquimod were used. Patient had complete remission with no further recurrences. Distinction between VVC and BLT can be difficult; current literature considers them different entities. Human papillomavirus (HPV) infection and the presence of LS play a controversial role in these injuries.

Successful ablation of giant condyloma acuminata in an adolescent

Condyloma acuminata are usually associated with persistent and recurrent infections and early surgical intervention is often required to prevent recurrences. The Buschke–Löwenstein tumor, a locally invasive, slow-growing, cauliflower-like growth, is an example of a giant condyloma acuminatum. Herein, we report a case of sexually-acquired perianal giant condyloma acuminata in a fourteen-year-old male successfully treated by electrofulguration with radiofrequency cautery under general anesthesia in a single session with no evidence of recurrence over a follow-up period of six months.

Case report: Buschke-Löwenstein tumor in a nonimmunosuppressed patient

The present work aims to report a case of Buschke-Lowenstein tumor (BLT), which is a mass of genital warts that usually affects immunosuppressed people. The reported case was diagnosed in a young patient with no known immunosuppression. Several tests were performed to confirm the diagnostic hypothesis, including immunohistochemistry, histological, molecular and imaging analysis. The results obtained were confirmatory in all analyses, except in the molecular one. Because BLT is a rare condition, there is still great literary heterogeneity regarding the ideal treatment, but some options can be considered, such as excision and radiotherapy.

Buschke-Lowenstein Tumor or Giant Acuminous Condyloma Cininical and Therapeutic Aspect about a Case (At the Mohamed V Rabat Military Training Hospital)

The Buschke-Lowenstein tumor (TBL) or giant condyloma acuminata (GAG) is a tumor of viral origin with predominantly sexual transmission. A rare nosological entity 0.1%. Affecting men in 80% of cases and developing on the sexual organs perineum in women, the manifestation is in about 90% on the vulva. The contributing factors are the multiplicity of sexual partners, repeated infections, and decline in humanity. The condition phase is characterized by a cauliflower or rooster's crest tumor. Treatment is primarily surgical, followed by clinical and histological monitoring. We report a clinical case of giant condyloma acuminata at the Military Hospital of Instruction Mohamed V Rabat from 01/15/2021 TO 01/22/2021, the patient is operated with favorable outcome: seen on D 30 post-op.

Radical surgical management of perianal giant condyloma acuminatum of Buschke and Löwenstein: long-term results of 11 cases.

Perianal Buschke-Löwenstein tumor (BLT) is characterized by an exophytic cauliflower-like mass surrounding the perianal region. Its tendency to infiltrate the adjacent tissues, its massiveness, and its high recurrence rate cause difficulties in treatment. The aim of this study is to report our strategy with wide local excision and flap reconstruction for BLT. From November 2002 to June 2019, 11 patients (9 men) with a mean age of 33.45 years (range, 19-54 years) were operated on for BLT. All patients underwent wide local excision and V-Y flap reconstruction, supplemented with other flaps whenever needed. No additional modalities were used. Two patients had a history of anal intercourse while all patients were human immunodeficiency virus-negative. The mean tumor length was 15.54 ± 1.34 cm (range, 10-26 cm). Human papillomavirus 6 was the most common type identified. Partial wound dehiscence developed in 3 patients, while anal stenosis, mucosal ectropion, or local recurrence was not observed during the mean follow-up period of 50.45 ± 1.75 months (range, 10-196 months). In patients with perianal BLT, wide local excision and flap reconstruction result in a high healing rate without significant complications.

Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage.

Giant condyloma acuminatum (GCA) or Buschke-Loewenstein tumor is a rare disease, with an estimated prevalence of 0.1%. It was initially described in 1896 by Buschke and later in 1925 by Buschke and Loewenstein. Classic condyloma acuminata (CCA) and squamous cell carcinoma (SCC) were initially described as different entities. These three entities are currently considered to correspond to the same spectrum of different but not exclusive malignant transformations, associated with multiple risk factors such infection by human papilloma virus (HPV), immunodeficiencies, poor hygiene, multiple sexual partners, and chronic genital infections. HPV subtypes 6 and 11 are associated with 90% of GCA. It presents as a cauliflower-like tumor in the genital region with bad odor, bleeding, and local infection, differential diagnosis with multiple conditions should be considered, and sexually transmitted diseases should always be investigated. GCA has a higher rate of malignant transformation than CCA and tends to infiltrate adjacent soft tissues. The therapeutic approach is controversial but is considered that the resection with free edges is the gold standard and can be combined with adjuncts. The recurrence rate is high. Overall mortality is 21% and is associated with morbidity caused by recurrences. Imiquimod cream 5% has recently shown good results as monotherapy and in combination with ablative and surgical treatments. The quality of life is diminished in patients with this condition. In this review, we address the different aspects of this rare entity including the therapeutic approach.

Unique hybrid double apposing flap in a Z-plasty technique to reconstruct major perianal defect resulting from chondyloma acuminatum resection - Case report.

Perianal area is anatomically challenging location to reconstruct after wide extensive local excision especially when preserving the anus anatomy anal sphincter continence is a requirement. That is the case in many benign locally aggressive conditions, due to high risk of suture line disruption, wound dehiscence, and wound infection. Many surgical options like primary closure, loco reginal flaps, distant or pedicled flaps, or even free flaps are available for such reconstruction. This is a report of a case of locally aggressive infection that was initially confused as complex perianal fistula, then sarcoma after the initial resection. Surprisingly, the permanent pathology confirmed the diagnosis of a giant condyloma acuminatum extending to the anal area, for which an extensive wide local resection with margin and temporary colostomy was done, this resulted in a large defect necessitating a reconstruction with hybrid double apposing Superior gluteal artery perforator flap (SGAP flap) and Inferior gluteal artery perforator flap (IGAP flap) in Z-plasty fashion. That healed completely with no local complication.

Case Report: Successful Treatment of Giant Condyloma Acuminata with Intralesional Injection of Purified Protein Derivative

Condyloma acuminata can be treated with different modalities, including topical and destructive procedures. However, treatment of large recalcitrant lesions tends to be difficult with the risk of pain, scarring and recurrence. Here we report a case of a large foul-smelling condyloma acuminata, treated successfully with intralesional purified protein derivative (PPD) injections.

Buschke-Lowenstein Tumors: A Review and Proposed Classification System.

Buschke-Lowenstein (B-L) tumors or giant condylomata are large fungating lesions that are caused by human papillomavirus (HPV) and develop in the anogenital region. Although uncommon, physicians and surgeons who treat sexually transmitted diseases or other diseases involving the anogenital area will encounter these patients. The purpose of this study is to review the current literature regarding these lesions. We evaluated every published study in PubMed and Embase from 1925 to 2020, concentrating on the clinical data included in each report, such as presentation and treatment. We also evaluated each work for any definition used and found that there is no accepted definition for these lesions. As such, we provide an inclusive, workable definition. In addition, there are many misconceptions about B-L that continue to be propogated as more case reports are published every year. After evaluating every published case, we refute the fact that these lesions have a high mortality or a high malignancy rate. Furthermore, we refute that these lesions are synonymous with verrucous carcinoma. In addition to a definition, we also propose a simple grading system that we hope can be used to assist in the study and management of these patients moving forward. Although the literature is very heterogenous regarding B-L, they are caused by HPV and are distinct from verrucous carcinoma. Because of the majority of information is based on case reports, the literature concentrates on treatment, but more work is clearly needed to delineate the association with specific HPV types and optimal management of this disease.

Clinical Anatomopathological and Therapeutic Aspects of Buschke-Lowenstein Tumor

Introduction: Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. Patients and Method: Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. Result: A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. Conclusion: BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.

Gaint Condylomata Acuminate of Buschke-Lowenstein in Woman with HPV Infection: Clinical Presentation and Treatment

Buschke-Lowenstein Tumor (BLT) is a very rare sexually- transmitted disease associated with human papillomavirus type 6 and 11, but rare cases of oncogenic HPV types including HPV 16 and HPV 18 were also reported. BLT is located in the genital, anorectal and perianal regions. It is regarded as a type of verrucous carcinoma occurring on anogenital mucosal surfaces where it is locally invasive but displays a benign cytology. Buschke-Lowenstein tumor can be associated with a high rate of recurrence and a risk of malignant transformation to invasive SCC, especially in patients with oncogenic types of HPV. We report the case of a 59-year-old female patient who addressed our clinic for a large, exophytic, cauliflower-like tumor involving the vulva, perineum and perianal regions with 20 years duration. The first lesions had been appeared on vulva and after 3 years period they grown slowly and covered perineum and perianal area. They had cauliflower like surface, with different sizes. In some points erosions and yellowish secretion with odor are observed. Histologic examination of a biopsy specimen of large tumor presented nets of well- differentiated squamous cell carcinoma, as well as a marked mononuclear cell infiltrate and conspicuous koilocytosis. HPV DNA for 6 and 11 types was detected with PCR. The patient was sent to the gynecology surgery department for excision and remains under the supervision of the dermatology and oncology department for rapid treatment of relapses and early detection of malignant transformation.

An unexpected giant problem — Giant condyloma (Buschke–Lowenstein tumor)

A 49-year-old man with a long-standing history of alcohol abuse was admitted to the Nephrology Department because of acute kidney injury. Previous medical history was unremarkable. Physical examination revealed severe dehydration and a large (15 × 25 cm) verrucous mass (Figure 1A) with an associated ulceration localized in the anal region. Small verrucous lesions were also localized on the lower abdomen and scrotum (Figure 1B). Testing for human immunodeficiency virus and syphilis was negative. Histopathology of the lesions was notable for papillomatosis and hyperkeratosis defining condyloma acuminata.

Giant Condylomata Acuminata or Buschke-Löwenstein Tumour: Clinic and Dermoscopy

The Buschke-Löwenstein tumor, also known as, giant condyloma acuminatum is an extremely rare sexually transmitted disease associated due to human papilloma virus infection, mostly Type 6 or 11.

Management of giant condyloma acuminatum on HIVAIDS patients with limited healthcare facilities

AbstractGiant Condyloma Acuminatum (GCA) or Buschke-Lowenstein Tumour (BLT) is a unique variant of condyloma acuminatum. The incidence of this disease tends to increase due to the increasing prevalence of Human Immunodeficiency Virus (HIV) infection. Until now, there is no therapeutic guideline for GCA, and many therapeutic options are not available for one in limited healthcare facilities. We present one case of GCA in HIV-positive women treated in health centers with limited facilities in a rural area. We treat the patient by doing a sitz bath with povidone-iodine 1%, simple excision with electrocautery for the tumour, adequate analgetics, regular wound care, and zinc supplementation acts as immunotherapy. Complications of wound infection by candida caused the lengthy hospitalization of the patient. After discharge, the patient came for control every week; no other lump arises again, and the wound was getting better. A combination of conservative and surgical treatment followed by regular wound care can lead to a good result in the GCA case, even with minimal healthcare facilities.

A case of Buschke-Lowenstein tumor with hypogastric extension

A case of Buschke-Lowenstein tumor with hypogastric extension

A study of sexually transmitted infections among HIV – infected patients in correlation with their CD4 T cell counts

Sexually transmitted infections is most common infectious disease for public health. Human immunodeficiency virus (HIV) alters the clinical presentation of sexually transmitted infections, their natural history, relative prevalence and response to treatment. To study the sexually transmitted infections and their correlation with the CD4 T cell counts among HIV – infected patients. Department of dermatology, venereology and leprology, tertiary care hospital, Cross-sectional study. A total of one hundred and fifty-five cases of HIV seropositivity were studied over a period of twelve months. A detailed history covering all relevant points was recorded in all cases. Each patient underwent a thorough general, physical, systemic, dermatological and venereological examination. Twenty-five out of one hundred fifty-five cases had sexually transmitted infections. All relevant investigations were done and data was recorded.Statistical analysis used: Data analysis was done using Statistical Package for Social Sciences (SPSS) v.21 for windows and Chi-square test was used. Out of the twenty-five patients, nineteen were males, five females and one transgender. Maximum numbers of patients were between the age group of 31-40 years. Most common sexually transmitted infection was herpes progenitalis (64%). Others were genital warts (16%), balanoposthtitis (8%), gonorrhea (4%), syphilis (4%), buschke-lowenstein tumour (4%) and genital molluscum contagiosum (4%). There is a strong association between the occurrence of HIV and the presence of sexually transmitted infections. Both HIV and sexually transmitted diseases are closely interlinked. So, early diagnosis, treatment and control of sexually transmitted diseases offer a rational approach to the management.

Giant Buschke-Löwenstein Tumor: a Successful Challenging Radical Surgery

Buschke-Lowenstein tumor (BLT) is a rare sexually transmitted disease and is commonly discovered in advanced stage where the surgical excision leaves large skin defect. We report herein the case of a 29-year-old man presenting with locally advanced giant BLT after 6 years of neglect, involving the proximal two-thirds of the penis in addition to the suprapubic region. The mass was radically excised in one fragment. The suprapubic defect was closed by using bilateral parallel relaxing incisions, and the degloved penis defect was closed by tension free simple interrupted suture. The patient declares having erections with no deviation or pain 3 months after surgery. Urologists should have plastic surgery experience so they can ensure excellent cosmetic and functional outcomes as demonstrated in our patient.

Buschke-Löwenstein tumour (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight

Buschke Löwenstein tumor (BLT)/giant condyloma acuminatum is a rare variant of sexually transmitted infection caused by human papillomavirus (HPV) type 6 and 11. HPV has its viral factors that exist to avoid immune surveillance and control through 1) infecting only the basal layer of the epithelium, 2) downregulation of host immunity, 3) suppression of proinflammatory proteins essential for viral clearance. The incidence of BLT/GCA is estimated to be 0.1% in the general population, with males having 2.7 times increased risk than females. BLT/GCA is characterized by verrucous tumor or palpable cauliflower-likemass, exophytic growth, flesh-colored, and uneven surface. The definitive diagnosis of BLT/GCA is typical morphology along with histopathological examination, and/or viral serotyping. Treatment of BLT/GCA requires a multidisciplinary approach, determined based on age, the extent of the lesion, organ involvement, and organ location.

Buschke-Löwenstein tumour (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight

Buschke Löwenstein tumor (BLT)/giant condyloma acuminatum is a rare variant of sexually transmitted infection caused by human papillomavirus (HPV) type 6 and 11. HPV has its viral factors that exist to avoid immune surveillance and control through 1) infecting only the basal layer of the epithelium, 2) downregulation of host immunity, 3) suppression of proinflammatory proteins essential for viral clearance. The incidence of BLT/GCA is estimated to be 0.1% in the general population, with males having 2.7 times increased risk than females. BLT/GCA is characterized by verrucous tumor or palpable cauliflower-likemass, exophytic growth, flesh-colored, and uneven surface. The definitive diagnosis of BLT/GCA is typical morphology along with histopathological examination, and/or viral serotyping. Treatment of BLT/GCA requires a multidisciplinary approach, determined based on age, the extent of the lesion, organ involvement, and organ location.

P-03-5 Giant Vulvar Condyloma Acuminata Treated Successfully With Intralesional Tuberculin Purified Protein Derivative: A Case Report

Giant condylomata acuminata (Buschke-Löwenstein tumor), represents a rare, sexually transmitted disease, usually resulting from infection with human papillomavirus (HPV) types 6 and 11. It is a challenging condition which is difficult to manage with both surgical and medical methods. The purpose of this article was to stress the importance of immunotherapy in treating such cases without disrupting the normal anatomy. The case was a 20 years old married female patient presented with a 14 cm x 10 cm exophytic mass of the vulva in addition to smaller masses extending to the internal vaginal wall and perineum for 4 months duration. Biopsy confirmed that it was a giant condyloma accuminata without evidence of cytological atypia or malignancy. Workup included a pap smear, human immunodeficiency virus (HIV) serology and pelvic magnetic resonance imaging and all were negative. The lesions were treated successfully with 6 sessions of intralesional immunotherapy with tuberculin purified protein derivative (PPD) vaccine. Complete resolution of lesions was obtained after 3 months and there was no recurrence after 1 year of follow-up. By the end of the sessions the patient had a successful sexual intercourse and her quality of life had been improved.