Giant Condyloma Acuminatum Research Articles

Giant Condylomata Acuminata of Buschke-Lowenstein Associated With Paraneoplastic Hypercalcemia.

Low-risk human papillomavirus types 6 and 11 can manifest as giant condylomata acuminata (GCA) of Buschke-Lowenstein. Up to 50% of GCA can slowly progress over years to fungating, invasive tumors. The malignant potential is attributed to unique immune evading abilities of the human papillomavirus. A 42-year-old male presented with pain and foul-smelling discharge from his genital warts. The histopathological examination of the mass showed invasive squamous cell carcinoma, and it was associated with paraneoplastic hypercalcemia. The timely removal of long-standing GCA in order to prevent a carcinomatous transition is a priority.

Perianal Giant Condyloma Acuminatum Treated with Topical Zinc Oxide Starch Powder

Perianal Giant Condyloma Acuminatum Treated with Topical Zinc Oxide Starch Powder

A Case of a Giant Condyloma Acuminatum Treated by Surgical Resection Leaving Wounds Open

A Case of a Giant Condyloma Acuminatum Treated by Surgical Resection Leaving Wounds Open

Radical Excision of a Buschke-Lowenstein Tumor and Excellent Reconstruction of the Tissue with Cutaneous Flap and Split-thickness Skin Graft

Radical Excision of a Buschke-Lowenstein Tumor and Excellent Reconstruction of the Tissue with Cutaneous Flap and Split-thickness Skin Graft

A clinical study on genital warts and HIV in Bangladesh

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Like other sexually<strong> </strong>transmitted diseases (STD), ano-genital warts (AGW) is associated with human immunodeficiency virus (HIV) infection and this study of AGW was conducted among HIV positive and HIV negative patients. The aim of the study was to study the risk factors and clinical presentations of ano-genital warts in HIV infected patients</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Northern part of Bangladesh from July 2015 to December 2016. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Significant association of HIV positivity (p<0.05) was<strong> </strong>observed between age group of 15-30 years and HIV negative status (p<0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p<0.01), homosexuality (p<0.05) and presentation with anal warts (p<0.01). HIV negative status correlated significantly with single sexual partner admission (p<0.01) and hetero-sexuality (p<0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in seropositive group, did not show any significant association with HIV positivity (p>0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein tumour (BLT)</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">HIV positivity was significantly associated with<strong> </strong>the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant AGW. Follow up of these patients with human papilloma virus (HPV) sub-typing is necessary. </span></p>

Case report: An HIV + patient presenting with pancytopenia, hepatic failure, and coagulopathy; a rare small cell liver carcinoma with diffuse splenic and bone marrow metastasis diagnosed at autopsy

A 34-year old male with a giant condyloma acuminatum of the anus secondary to HIV infection presented to the emergency department with a persistent nose bleed lasting 2–3days, acute anemia, thrombocytopenia, and coagulopathy. The patient also had significant hepatosplenomegaly and elevated liver enzymes which were a new finding since the patient's last hospitalization 1–2month prior to the current admission. A bone marrow biopsy showed diffuse infiltration by carcinoma with neuroendocrine features. The patient quickly developed multi-organ injury, decompensated, and died. An autopsy was obtained which established the diagnosis of small cell carcinoma of the liver.

Giant condyloma acuminatum of vulva

In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening). Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.

Atypical morphology of anogenital warts is not a marker of atypical histology or of infection to the high-risk human papillomavirus genotypes.

The clinical morphology of anogenital warts may vary from flat, filiform, papular, or verrucous to giant condyloma acuminatum. Clinically atypical-looking genital warts may alarm the clinician because of their suspected malignant potential, which may cause anxiety, often leading to aggressive interventions. To study if clinically atypical-looking anogenital warts are more likely to be premalignant or malignant as compared to typical warts. Data of 41 (37 males, 4 females) patients with anogenital warts was retrospectively analyzed. After a detailed literature review and in-house discussions, criteria for anogenital warts with typical and atypical clinical morphology were defined. Clinical photographs were independently reviewed by three dermatologists, and human papillomavirus (HPV) genotyping results, histological evaluation, and immunohistochemical analysis for p53 expression were evaluated. Fifteen (36.6%) anogenital warts were classified as atypical by at least two of three blinded dermatologists. The histological examination showed mitotic figures in 31/41 (75.6%) specimens, dysplasia in 14/41 (44.1%) specimens, and p53 positivity in 34/41 (82.9%) specimens. There was no significant difference in the high-risk HPV genotyping (P = 0.67), frequency of dysplastic changes on histology (P = 0.19), and immunohistochemistry with p53 (P = 0.08) between clinically typical and atypical-appearing anogenital warts. Similarly, no significant difference was found in the frequency of dysplastic changes (P = 0.67) or p53 expressions (P =0.41) based on the HPV genotypes. The atypical clinical morphology of anogenital warts may not be a marker of increased malignant potential. High-risk HPV genotypes do not have a statistically significant association with dysplasia or positive immunohistochemistry with p53.

Buschke-Lowenstein Tumor

Giant Condyloma acuminatum (GCA) , or Buschke-Lowenstein tumor (BLT), is a slow-growing, locally destructive, rare tumor that may occur in the anogenital region and it is related to human papillomavirus (HPV), which was first described by Buschke - Lowenstein in 1925. After consulting the databases of Latin American and Caribbean Literature (LILACS) and International Literature in Health Sciences and Biomedical (PubMed), without temporal delimitation or study design, using the MeSH terms "vulvar neoplasms," "giant condyloma of Buschke and Lowenstein", "condylomata acuminate”, we found 24 articles. After exclusion of the articles that did not address the BLT, it remained ten cases reported in the literature. We reported a case of BLT that clashes with the profile described in the literature. Consent was obtained from the patient for publication of the case and images.

128 Surgical Excision for Management of Genital Giant Condyloma Acuminata

128 Surgical Excision for Management of Genital Giant Condyloma Acuminata

Buschke-Lowenstein tumors

Agiant condyloma acuminatum which shows destructive growth but lacking invasion is designated as aBuschke-Lowenstein tumor (BLT). Classification of the BLT and therapeutic guidelines are provided. AMEDLINE literature search from 2006-2016 was performed. Induction through low-risk mucosotropic human papillomavirus (HPV) infection separates BLT from verrucous carcinoma. In the last 10years, slightly more than 100new cases have been described. Invasion as atrue sign of malignancy was described in 12% of cases. HIV infection was observed in 14%. As invasion often occurs only focally and may only be detected after complete resection, BLT must be treated and considered as alow grade in situ epithelial cancer that evolves from condylomata acuminata. Diagnosis is confirmed by HPV detection and typical histology. CT scans are recommended to rule out deeper invasion. Organ preservation surgery remains the recommended therapy. Buschke-Lowenstein tumors represent low grade epithelial in situ carcinomas which evolved from condylomata acuminata. Focal invasion is frequent but metastases occur only rarely. Organ preservation surgery is recommended.

Management of Giant Ano-Vulvar Condyloma in a Structure with Limited Resources

Buschke-Lowenstein Tumor (BLT) or Giant Acuminate Condyloma (GAC) is an uncommon clinical entity rarely published in Cote d’Ivoire and Africa. It is a viral infection with increasing sexual transmission due to the resurgence of HIV infection. This observation is the first case recorded in our service in three decades. The treatment is resolutely surgical, in our context of sub-medicalization, in the absence of other therapeutic means. Most of the time the progression is favorable, but the prognosis can be aggravated by the HIV coinfection. Through this observation, the authors insist on the prevention of all sexually transmitted infections, particularly, with HPV and HIV, by sexual education (abstinence, fidelity, port of condom) and the systematic vaccination before any sexual activity.

Ano-Genital Warts and HIV Status- A Clinical Study.

Ano-Genital Warts (AGW) like other Sexually Transmitted Diseases (STD) is associated with Human Immunodeficiency Virus (HIV) infection. This study of AGW was done in HIV positive and HIV negative patients. To study the risk factors and clinical presentations of ano-genital warts in HIV positive and negative patients. A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Dr. D. Y. Patil Hospital and Research Centre from July 2014 to July 2016. Significant association of HIV positivity (p<0.05) was observed between age group of 15-30 years and HIV negative status (p<0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p<0.01), homosexuality (p<0.05) and presentation with anal warts (p<0.01). HIV negative status correlated significantly with single sexual partner admission (p<0.01) and hetero-sexuality (p<0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in ser-positive group, did not show any significant association with HIV positivity (p>0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein Tumour (BLT). HIV positivity was significantly associated with the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant ano-genital warts. Follow up of these patients with Human Papilloma Virus (HPV) sub-typing is necessary.

Giant Condyloma Acuminatum in a Woman with AIDS

Objective: To describe a case of Giant Condyloma Acuminatum with aspect of HIV and some concerns about the CD4.&#x0D; &#x0D; Result: We describe 2 cases, the first case is a giant Condyloma in HIV patient and the second case is a giant Condyloma in pregnant woman. The patient in the first case was a 40-year-old woman with AIDS (CD4 is 290) who was undergoing anti-retroviral therapy. She was found to have a giant condyloma acuminatum of the vulva. Electrocautery excision was performed, and afterwards the quality of life has improved significantly. The second case patient is a 30-year-old G4P3A0 woman with a giant condyloma acuminatum. She was 30 weeks pregnant with a single fetus. On the external genitalia there was a giant condyloma mass on the vulva extending towards the&#x0D; peri-anal area, obstructing the introitus. The electrocautery excision was performed. She was discharged from the hospital on the second day in good condition. She had a spontaneous delivery after reaching&#x0D; full term.&#x0D; &#x0D; Conclusion: Although the giant Condyloma Acuminatum is combined with HIV, but it’s not as difficult as imagined because the tumor’s base is not wide, but shaped like inverted mushroom and it is not necessary to do local flap reconstruction.&#x0D; [Indones J Obstet Gynecol 2012; 36-4: 206-10]&#x0D; &#x0D; Keywords: electrocautery excision, giant condyloma acuminatum, surgery in AIDS

Tumeur de Buschke-Löwenstein: à propos de 8 cas et revue de la littérature

ObjectivesPresent the clinical, pathological, histological and management of Buschke-Löwenstein tumor (BLT) at the National General Hospital of N’Djamena in Chad. Subjects and methodsA descriptive prospective study which collected 8 patients’ records presenting BLT from May 2009 to June 2012. The variables studied were clinical, paraclinical, therapeutic and evolutionary. The treatment consisted in a “resection-cauterization” under local or spinal anesthesia depending on the extent of the injury. For vulvar lesions, a fatty dressing separating the lips was done. Wearing the urinary catheter was necessary for all patients. ResultsEight patients were managed, two pregnant women and six men. The mean age was 28.87 years with extremes of 18 and 60. A patient was seropositive for HIV and syphilis. One patient had a recurrence after 5 months requiring a second “resection-cauterization” which was successful. Histological analysis of the tissue had found a BLT. The 2 pregnant women had delivered vaginally and fetuses were not contaminated. ConclusionBLT is a relatively common condition that affects young patients of the 2 sexes in urology. The “resection-cauterization” is the best treatment.

Tumor de Buschke-Lowenstein: Presentación de un caso y revisión de la literatura

&lt;p&gt;&lt;strong&gt;Objetivo:&lt;/strong&gt; presentar el caso de una paciente con tumor de Buschke-Lowenstein, y hacer una revisión de la literatura respecto a su diagnóstico y tratamiento.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materiales y métodos:&lt;/strong&gt; se presenta el caso de una paciente de 19 años de edad, con condiloma gigante de rápida evolución en la vulva, o tumor de Buschke-Lowenstein, a quien se le realiza vulvectomía parcial en un hospital de tercer nivel de referencia, ubicado en Bogotá, Colombia. Se realizó una revisión de la literatura registrada en las bases de datos Medline vía Pubmed, EBSCO, ProQuest y SciELO, del 2000 al 2015; se incluyeron artículos de revisión y reportes de casos. Se consultaron los artículos publicados en inglés y español con los siguientes términos MeSH: “condiloma gigante”, “Buschke-Lowenstein”.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Resultados:&lt;/strong&gt; se identificaron 26 títulos, de los cuales se incluyeron 20 estudios. De ellos, 18 correspondierona reportes de caso, uno a una serie de casos y uno a un artículo de revisión. Su origen se encuentra frecuentemente ligado a la infección por VPH serotipos 6 y 11, y posee un bajo riesgo de malignidad. El diagnóstico se basa en la historia clínica y la exploración física, aunque el diagnóstico histopatológico es el patrón de oro. El tratamiento quirúrgico ha sido el más utilizado y se basa en la resección completa de la lesión. No hay información consistente sobre el tiempo libre de enfermedad.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusión:&lt;/strong&gt; el tumor de Buschke-Lowenstein constituye una entidad poco frecuente, cuyo abordaje diagnóstico requiere un alto índice de sospecha clínica. El tratamiento se basa en la resección completa de la lesión y, en algunas ocasiones, esta se acompaña de terapia adyuvante con el ánimo de disminuir las tasas de recurrencia. Se requieren más estudios que aborden el diagnóstico y el tratamiento de esta entidad.&lt;/p&gt;

Giant condyloma acuminatum of the anorectum: successful radical surgery with anal reconstruction.

Buschke-Löwenstein tumor, or giant condyloma acuminatum, is a relatively uncommon lesion of the anus with aggressive local invasive behavior which may present as a large warty tumor of the genital region with expansive and destructive growth. Many sporadic reports have been published suggesting various therapeutic strategies. We report a case of Buschke-Löwenstein tumor treated with conservative surgery followed by reconstructive procedures without a loop colostomy

INDINOL FORTO AND EGALLOHIT IN THE TREATMENT OF CONDYLOMA ACUMINATE AND GIANT CONDYLOMA

Генитальная папилломавирусная инфекция – одна из самых частых инфекций, передаваемых половым путем. Однако ее лечение все еще недостаточно эффективно и нередко сопровождается рецидивами. В статье приводятся собственные данные по применению индолкарбинола (препарат Индинол Форто) у 75 больных, страдавших остроконечными кондиломами половых органов или перианальной области, кондиломами Бушке – Левенштейна и бовеноидным папулезом, с целью профилактики рецидивов генитальных бородавок после фотодинамической терапии (ФДТ), криодеструкции, электрокоагуляции, аппликации Мардил Селеном. Удаление гигантских кондилом Бушке – Левенштейна у 7 больных проводилось методом ФДТ, по окончании которой на очаг поражения наносился гель Эгаллохит. Индолкарбинол применялся по 400 мг/сут в течение 3 месяцев в комплексе с интерфероном альфа-2b (препарат Виферон) по 1 млн МЕ в сутки в течение 1–3 месяцев. Рецидивов после лечения генитальных бородавок в сроки наблюдения от 5 месяцев до 9 лет (в среднем 3,9±2,7 года) не было. Применение Эгаллохита обеспечивало формирование на месте излеченных методом ФДТ гигантских кондилом Бушке – Левенштейна тонких, приемлемых в косметическом отношении участков рубцовой атрофии. Подробно описаны три клинических наблюдения пациентов с гигантской кондиломой Бушке – Левенштейна.

Giant Condyloma Acuminata in Indonesian Females with SLE under Immunosuppressant and Steroid Therapy.

Introduction. Immunosuppressant and steroid therapy in systemic lupus erythematosus (SLE) increases the risk of human papillomavirus (HPV) infections, one of which is giant condyloma acuminata (GCA). To our knowledge, there is no report evaluating the correlation between immunosuppressive and steroid therapy in patients with SLE and the prevalence of GCA. Case Report. A 42-year-old female was diagnosed with SLE a year ago and has been treated with steroids and immunosuppressive drugs. In the last few months she presented GCA involving the genital area recurring almost every two months. Type 6 and 11 HPVs were identified in vulva, vagina, and cervix. Methods. PubMed, EBSCO, and Cochrane Library literature were searched from inception to July 2015. Authors screened all titles and abstracts and read full text article, and two case-control studies were found relevant. Results. SLE patients in both studies were under immunosuppressive and steroid therapy. Condyloma acuminata was diagnosed at 108 months (latest) and 1 month (earliest) after SLE. Type 6, 11, 16, 42, and oncogenic group of HPV were identified. Conclusions. GCA is a type of HPV infection seldom observed in SLE patients. Therefore, their correlation is still unclear. Period of time since SLE was diagnosed and GCA varies from months to years. A more thorough physical and laboratory examination leading to HPV and other infectious disease is recommended.

An Unusual Finding of Buschke-Lowenstein Tumor Associated with 6, 39 and 53 HPV Genotypes in a Young Immunocompetent Female

Background: Buschke-Lowenstein tumor (BLT) or giant condyloma acuminatum (GCA), is a rare disease caused by Human Papilloma virus (HPV) types 6 and 11, more common in immunocompromised males. We describe a rare case of BLT associated with mixed low and high-risk HPV type’s infection in a very young immunocompetent female. Methods: On August 2012, an 18-year old female was admitted to the Unit of Obstetrics and Gynecology, with a 3-4 month history of small excrescences in the perineal/vulvar area which had rapidly increased in size. A diagnosis of BLT was suspected; an incisional biopsy was carried out. On the cervical and vulvar cytobrush samples, Polymerase Chain Reaction (PCR) of specific sequences of the HPV genome L1 region was performed. Surgical treatment was carried out by cold knife excision. Results: Clinically, the tumor presented as exophytic white lesion, characterized by an irregular surface with acuminate excrescenses. Microscopic images are consistent with diagnosis of Buschke-Lowenstein tumor. Performed PCR revealed the presence of HPV types 6, 39 and 53. After surgery the patient showed no signs of recurrence during the 4 years of follow-up. Conclusions: This report a rare case of BLT in a young immunocompetent female, associated with multiple HPV type infection. The studied case suggests that pathologies with a BLT-like clinical and histological presentation and mixed HPV genotypes can be found in young immunocompetent patient.