Giant Condyloma Research Articles

Renal transplantlı bir hastada hızlı gelişen dev kondiloma akuminatum: olgu sunumu

Giant condyloma acuminatum (GCA) usually occurs on a set of human papillomavirus (HPV) subtype 6 or 11 infections and is characterized by cauliflower-like aggressive growing mass over the anogenital region. Lesions are more often observed in immunocompromised patients since host immunity is one of the main risk factors of the disease. We report a case of a GCA in a sexually inactive renal transplant recipient. A 25-year-old patient who had renal transplantation four years prior and has been receiving immunosuppression therapy since presented with the rapid growth of a vulvar mass noticed. A wide surgical excision was performed and the patient had no recurrence at her follow-ups. Surgical excision is the definitive treatment in immunocompromised patients with the rapid growth of vulvar condylomas.

Electrosurgery on Giant Condyloma Acuminata

Giant Condyloma Acuminata (GCA) is a sexually transmitted infection caused by Human papillomavirus (HPV) types 6 and 11. GCA lesions can growth up to 10 cm and form like a cauliflower shape. This infection can affect patient’s quality of life. The goal of therapy in GCA is to remove all skin lesions, which can be done by surgical treatment. Many modalities have been tested in GCA cases, one of which is electrosurgery. The aim of this study was to evaluate effectiveness of electrosurgery for GCA. A 43-year-old woman came with complaints of warts appeared in the genital area since 3 months before. Examination showed multiple papules with a verrucous surface, size around 7 cm in the labia majora, labia minor and perineum. The acetowhite examination and histopathology lead to the diagnosis of condyloma acuminata. Electrosurgery (electrodesication) to remove GCA lesions divided into 2 times. Post-operative evaluation, patient did not complain of pain and erythema, edema, and pus. Electrosurgery is a therapeutic modality that can be chosen in cases of GCA. Electrosurgery, like other surgical modalities, is capable of removing the entire lesion, but the advantages of electrosurgery include not injuring large areas, minimal bleeding and a lower recurrence rate when compared to other therapeutic modalities.

Cutaneous Verrucous Carcinomas: A Review.

Verrucous carcinoma (VC) is a relatively rare locally aggressive, slow-growing, well-differentiated squamous cell carcinoma with minimal metastatic potential and is most frequent in the mucosa. Although rarely reported on the skin, cutaneous verrucous carcinomas (CVC) can appear anywhere, most commonly on the feet. However, clinical and pathologic diagnosis of CVC has been confusing and challenging. It can easily be mistaken for benign or more malignant conditions such as giant condyloma acuminata, keratoacanthoma, and pseudoepithelioma-like hyperplasia or squamous cell carcinoma, resulting in inappropriate management. In this review, we describe the different aspects associated with CVC, including its pathogenesis and clinicopathologic features. The available evidence for the differential diagnosis and treatment of CVC is discussed, and specific management recommendations are made. After the treatment, careful follow-up examinations of the excised area should be performed at regular intervals.

Relationship between Clusters of Differentiation 4 Count and Type of Human Papilloma Virus with Giant Condyloma Acuminata

BACKGROUND: Condyloma acuminata (CA) is a sexually transmitted infection caused by the human papilloma virus (HPV). HPV infection is increasing in immunosuppressed patients which causes the development of CA lesions to be longer, recurrent, and larger. Clusters of differentiation 4 (CD4) count showed an association with the occurrence of giant condyloma acuminata (GCA). AIM: The aim of the study was to determine the relationship between CD4 count and type of HPV with GCA. SUBJECTS AND METHODS: This study was an analytic and observational study with a cross-sectional design with 20 human immunodeficiency virus-infected subjects (10 GCA and 10 non-GCA) selected using the consecutive sampling technique. CD4 examination using blood samples which were analyzed using fluorescence-activated cell sorting. CA lesions were taken using a shave biopsy technique and then the HPV type was examined using the polymerase chain reaction method. RESULTS: The majority of the study subjects were male with GCA 7 people (41.2%). The most age group was 26–35 years old with GCA 6 people (66.7%). The education of the subjects was mostly senior high school with GCA 9 people (56.2%). The employment of the subjects was mostly service and sales personnel with GCA 4 people (57.1%). Based on the location of the GCA lesions, there were 4 people (57.1%) in the genital area and 6 people (46.2%) in the anal area. A total of 9 people (90%) with GCA had severe immunosuppression. The results of the analysis showed that there was a significant relationship between CD4 count and GCA (p < 0.001). The most common HPV type in GCA was HPV-11, amounting to 6 people (46.2%). The results of the analysis showed that there was no significant relationship between the type of HPV and GCA (p = 0.275). CONCLUSION: There is a significant relationship between CD4 count with GCA and there is no relationship between type of HPV with GCA.

Verrucous Carcinoma of the Uterine Cervix Arising in a Giant Condyloma Acuminatum, Associated with Ichthyosis of the Endometrial Cavity

We describe a unique presentation of a cervical verrucous carcinoma (VC) associated with ichthyosis of the uterine cavity in an 80-year old woman. Areas of transition from a giant condyloma (GC) were present in the VC. This paper also includes a review of the relevant literature. VC of the cervix is an uncommon malignancy, and transition of a GC to VC is an interesting finding, confuting the theory that they represent distinct entities, with different risk factors. Differently from GC, VC is considered to be causally related to HPV in a minority of instances. Our results of p16 immunohistochemistry, the surrogate marker of high-risk human papillomavirus (HPV) infection, appear to speak against the causal role of HPV in the pathogenesis of VC. Ichthyosis uteri may occasionally be associated with a cervical or endometrial malignancy; however, we are not aware of any patient showing VC, GC and ichthyosis uteri at the same time.

Buschke Lowenstein tumor (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight

Buschke Lowenstein 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. 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.

Giant Condyloma Acuminatum Covering the Vulva, Edges of the Labia Minora and Majora and Anus was Successfully Eliminated with MVA E2 Recombinant Virus Therapeutic Vaccination

Giant Condyloma Acuminatum Covering the Vulva, Edges of the Labia Minora and Majora and Anus was Successfully Eliminated with MVA E2 Recombinant Virus Therapeutic Vaccination

Anorectal Buschke-Löwenstein Tumor: A Case Report

Giant condyloma acuminata (GCA) or Buschke Lowenstein tumour (BLT) is a rare clinical entity of viral origin, transmitted essentially by sexual transmission, and is common in immunocompromised patients. It develops in the genital or perianal area, creating a large, bulging lesion that may be ulcerated or fistulised in neighbouring organs. The search for other associated sexually transmitted infections is mandatory. A rigorous clinical examination and additional imaging allow a precise assessment of the lesion to be made. Treatment is essentially surgical and must be extensive because of the tumour's high recurrencepotential. Neo-adjuvant treatments such as chemotherapy or immunotherapy deserve to be better evaluated to limit the disabling nature of surgery.

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

To show the effectiveness of combined cryotherapy and intralesional tuberculin purified protein derivative (PPD) in the treatment of giant condyloma accuminata. A 57-year-old female was presented with an extensive verrucous, ulcerated, cauliflower-like 10 × 5 cm mass of the perianal area with extension to labia majora. The mass had evolved progressively for 2 years and resulted in perianal discomfort, itching and bleeding. Histopathological examination ruled out the presence of malignancy and confirmed the diagnosis of condyloma accuminata.The lesions were treated by 6 sessions of combined cryotherapy (2 freeze thaw cycles 25 seconds each) and intralesional PPD with a dose of (0.3 ml each session) at two-week interval. The mass resolved completely after 3 months and the quality of life of the patient has improved dramatically. There was no recurrence within 1 year of follow-up. Although most case reports suggest surgical excision as the treatment of choice of giant condyloma accuminata, our case was successfully treated with a highly effective and safe combined modality of cryotherapy and intralesional PPD, with the advantage of preserving the normal anatomy and avoidance of post-surgical disfigurement. No conflict of interest to declare.

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

Giant Condyloma Acuminata - Buschke Lowenstein Tumor (About 3 Cases)

Buschke-Löwenstein tumor, or giant condyloma acuminata, is a rare viral disease, characterized by a potential for malignant transformation and invasion and recurrence after treatment. We report 3 cases of Buske-Lowenstein tumour. BLT was confirmed by biopsy and was treated by complete surgical resection. Treatment has not been clearly defined and is essentially based on surgery. Sexual education and early treatment of condylomatous lesions can improve the prognosis of this disease.

Cutaneous verrucous carcinoma: A clinicopathological study of 21 cases with long-term clinical follow-up.

BackgroundCutaneous verrucous carcinoma (CVC) is a rare variant of squamous cell carcinoma and sometimes shares similar clinical and histopathological features with other verrucous lesions.MethodsWe performed a retrospective study of 21 patients diagnosed with CVC between 2012 and 2022 by reviewing clinical and histopathological data. We also compared the clinicopathological features of patients with CVC, giant condyloma acuminatum (GCA), and pseudoepitheliomatous hyperplasia (PEH). We obtained follow-up data by reviewing medical records and telephone interviews.ResultsThe average age of patients with CVC was 63.6 years, with a male predominance. The location of disease is mostly found in the foot, followed by the lower legs. Histologically, CVC is characterized by an exo-endophytic growth pattern with severe keratinization and a blunted rete ridge with pushing margins. Clinical features including exudation and crusting, induration, irregular borders, and warty surface, as well as pathological features including growth pattern, koilocytotic cells, depth and morphologic features of acanthosis, severe keratinization, and degree of dermal inflammation, were significant in distinguishing cutaneous CVC, GCA, and PEH.ConclusionIdentification of the clinicopathological features is essential to distinguish CVC from its mimics and to make an early diagnosis. Because of the potential for recurrence and metastasis, CVC requires aggressive treatment.

Photogallery. Anogenital (venereal) warts

Anogenital warts are caused by the human papillomavirus (most commonly types 6 and 11, giant condylomas ― types 16 and 18) and are exophytic and endophytic growths on the skin and mucous membranes of the genital and perianal areas. There is no generally accepted classification, but based on clinical manifestations, there are: acute condylomas, papular, patchy, hyperkeratotic, and giant condyloma acuminatum (BuschkeLowenstein tumor). Anogenital warts can be the result of infection through sexual contact, which is indicated by the synonym venereal warts. Anogenital warts is a separate nosology (International Classification of Diseases of the Tenth Revision: A63.0), but can also be part of the symptom complex of immunodeficiency conditions (in particular acquired immunodeficiency syndrome) and neoplasias (squamous cell carcinoma and erythroplasia of Queyrat).
 We offer the publication of a photogallery on this problem.

The Pathogenesis of Giant Condyloma Acuminatum (Buschke-Lowenstein Tumor): An Overview.

Giant condyloma acuminatum, also known as Buschke-Lowenstein tumor (BLT), is a rare disease of the anogenital region. BLT is considered a locally aggressive tumor of benign histological appearance, but with the potential for destructive growth and high recurrence rates. BLT development is strongly associated with infection with low-risk human papillomaviruses (HPVs), mostly HPV-6 and -11. Immunity to HPVs plays a crucial role in the natural control of various HPV-induced lesions. Large condyloma acuminata are frequently reported in patients with primary (e.g., DOCK8 or SPINK5 deficiencies) and secondary (e.g., AIDS, solid organ transplantation) immune defects. Individuals with extensive anogenital warts, including BLT in particular, should therefore be tested for inherited or acquired immunodeficiency. Research into the genetic basis of unexplained cases is warranted. An understanding of the etiology of BLT would lead to improvements in its management. This review focuses on the role of underlying HPV infections, and human genetic and immunological determinants of BLT.

Human Papillomavirus High-risk Type Infection on Perianal Giant Condyloma Acuminatum

Background: Giant condyloma acuminatum (GCA) is a large form of condyloma acuminatum that become locally invasive, destructive, but non-metastasizing, caused by human papillomavirus (HPV). Giant condyloma is a rare disease, with only 0.1% incidence in the general population. Most commonly caused by HPV type 6 and 11 infections, in this case, reported HPV high-risk type.
 Case presentation: A 20-years-old man, the main complaint is enlarging, easy bleeding perianal tumor with pruritus and constipation for 2 months. Physical examination found skin-colored, verrucous surface. Some have smooth surface, cauliflower-like tumor on perianal region, size 7x4x2cm. Syphilis and HIV Serology laboratory tests are non-reactive. Koilocytes appear on histopathologic examination. High-risk HPV type detected on HPV genotyping. This patient was diagnosed as GCA. Topical agent 25% podophyllin tincture applied to the lesions once a week. Improvement appears after eighth-time therapy.
 Discussion: High-risk type HPV infection, detected in the patient, have an important role in GCA development. Decreased immune system and other risk factors also have a role in GCA.

Giant anogenital tumor of Buschke\u2013L\xf6wenstein in a patient living with human immunodeficiency virus/acquired immunodeficiency syndrome: a case report

BackgroundBuschke–Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke–Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients.Case presentationWe report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ‘’butterfly wing’’ structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm3) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke–Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection.ConclusionBuschke–Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.

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.

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.