Giant Condyloma Research Articles

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

Giant Cervical Condyloma During Pregnancy: A Case Report

Giant Cervical Condyloma During Pregnancy: A Case Report

Surgical Management of Giant Genital Condyloma Acuminata by Using Double Keystone Flaps.

Condyloma acuminata in the external genitalia (genital warts) is a sexually transmitted disease that is often caused by human papillomavirus (HPV). We report a case of giant genital condyloma acuminata in a 35-year-old male patient with HIV comorbidity treated by wide surgical excision. Excision defect was covered with split thickness skin graft (STSG) and double keystone flaps. There was no complication after surgery. Ten months following surgery, there was no new condyloma lesion and the patient had normal voiding and erectile functions.

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.

Giant Condyloma Acuminatum (Buschke-Lowenstein Tumor): A Case Report and Review of the Literature

Giant condyloma acuminatum (GCA) commonly known as Buschke-Lowenstein tumor is a rare, aggressive, slow growing; fungating variant of condyloma that is usually found in the genital and perianal regions but may affect any portion of the anogenital region. Although clinically malignant, its histology is benign without distant metastases. The incidence is 0.1% in the general population and while the prognosis is generally good with early diagnosis and proper treatment, mortality rates as high as 20% have been reported. Human papilloma virus (HPV) types 6 and 11are implicated as etiologic factors in the development of GCA. Radical surgical excision with clear histologic margins and plastic reconstruction remains the cornerstone treatment of choice, while preventing the incidence of recurrence. Topical agents and local destructive methods can be helpful for smaller lesions and immunotherapy as an alternative for widespread and relapsed cases. The authors report the case of a 51-year-old male patient with a perianal 8 × 7 cm Buschke-Lowenstein tumor who underwent total excision and plastic reconstruction with V-Y flap technique

English

English

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.

Гигантская кондилома Бушке–Левенштейна: принципы комплексного лечения

Гигантская кондилома Бушке–Левенштейна: принципы комплексного лечения

Surgical operation combined with aminolevulinic acid-based photodynamic therapy for the treatment of giant condyloma acuminatum: 12 case reports

Objective To evaluate the clinical efficacy of surgical operation combined with aminolevulinic acid-based photodynamic therapy (ALA-PDT) for the treatment of giant condyloma acuminatum. Methods Totally, 12 patients with giant condyloma acuminatum of the external genitalia and/or perianal region were enrolled, including 7 males and 5 females. Firstly, the warts were removed by surgical operation and bipolar electrocoagulation cautery. After wound healed, ALA-PDT was carried out at the lesional sites once every 7-10 days for 2-4 sessions. Results Within 6 months of follow-up, warts completely disappeared, and the acetowhitening test turned negative in all the 12 patients. Mild erythematous swelling occurred with pain and burning sensation after the operation, but no other adverse reactions such as infection, ulcer, or obvious scarring were observed. Conclusion Surgical operation combined with ALA-PDT is a relatively good choice for the treatment of condyloma acuminatum. Key words: Condylomata acuminata; Photochemotherapy; Aminolevulinic acid; Surgical procedures, operative; Clinical protocols

Giant Condyloma of the Uterus: Migrating Disease?

Giant Condyloma of the Uterus: Migrating Disease?

Giant Condyloma Acuminatum of the Scrotum, Bilateral Groins, and Suprapubic Region: A Treatment and Reconstruction Challenge

Giant Condyloma Acuminatum of the Scrotum, Bilateral Groins, and Suprapubic Region: A Treatment and Reconstruction Challenge

Circumferential anal giant condyloma acuminatum: a new surgical approach.

Perianal giant condyloma acuminatum is a rare clinical condition related to human papillomavirus infection and characterized by a circumferential, exophytic, cauliflower-like mass with an irregular warty surface localized in the anal region. A circular incision with a diathermocoagulator was performed on macroscopically healthy skin, 1 cm from the margin of the lesion. The dermis was divided from the subcutaneous tissue. This way, a mucocutaneous cylinder including the whole lesion was obtained. A median radial incision was carried out to open the cylinder at its front. A progressive circumferential section on healthy mucosa (≈1 cm above the margin of the lesion) by means of a radiofrequency dissector allowed for the complete removal of the mass. The healthy mucosa of the anal canal was pulled out by Allis forceps and was sutured to the external margin of the internal sphincter with single layer of Vicryl (polyglactin 910) 2-0 sutures. Two months after surgery, no findings of anal stenosis or mucosal ectropion were reported. At the 1-year follow-up there was no recurrence of condylomatosis in any of the 3 cases. Our procedure seems simpler to perform when compared with other techniques and reduces hospital stay and complications such as anal stenosis and mucosal ectropion.

Buschke Löwenstein Tumor of the Right Lower Abdominal Wall: Case Report and Review of the Literature

Buschke-Löwenstein tumor (BLT), known as giant condyloma acuminatum (GCA), is a very rare disease that typically appears as a penile lesion but can although appear in the anogenital region, bladder, vulva, scrotum and sacrococcygeal area as well. Despite of its histologically benign signs, a high recurrence rate, invasiveness and destructive growth characterizes this rare disease as clinically malignant. Malignant transformation into verrucous carcinoma (VC) and squamous-cell carcinoma (SCC) have been described as well. Many treatment modalities inclusive neoadjuvant radio-and chemotherapy and topical treatment have been reported but due to lack of controlled studies no treatment can be recommended. We present a case of Buschke-Löwenstein tumor involving the right lower abdominal wall of the colostomy region at a 71 years old male. To our knowledge, we first describe a case report of GCA involving abdominal wall at the colostomy region, successfully treated by wide radical excision and plastic reconstruction.

Giant Condyloma Acuminatum of Buschke and Lowenstein

A 55-year-old man without HIV infection history, presented with neglected giant peri-anal condyloma acuminatum evolving for more than 10 years. Histologic findings revealed a condyloma acuminatum of Buschke and Lowenstein tumor without verrucous carcinoma. A patient was admitted for radiation therapy in our department. Clinical examination revealed a huge infected mass, cauliflower-like, infiltrating the left buttock and perineum.

Electrocautery resection, shaving with a scalpel, and podophyllin: a combination therapy for giant condyloma acuminatum.

Giant condyloma acuminatum (also known as Buschke-Löwenstein tumor) is a rare disease, for which the treatment of choice is still controversial. In the case described in this report, we used a combination of electrocautery and a surgical scalpel to resect a huge genital wart, followed by long-term local treatment with podophyllin. This procedure was relatively fast, easy to perform, involved minimal bleeding, and did not result in any complications. Moreover, combination therapy enabled us to avoid deep resection of the lesion and consequently, sexual function was preserved completely.

The treatment of giant periurethral condyloma in pregnancy using an ultrasonic thermal scalpel: a case report and new single session treatment option.

Multiple large polypoid lesions with exophytic appearance occurring in anal and perineal region as a result of human papilloma virus (HPV) infection are referred to as giant condyloma acuminatum (GCA). The conventional treatment of these lesions involves the use of surgical excision, laser, electrocautery, and/or application of trichloroacetic acid. A 28-year-old primigravid patient at 22 weeks of pregnancy presented to the hospital complaining of vaginal bleeding and palpable mass in the vulva. The physical examination revealed a 60 × 35 mm broad-based, fragile, and patchy hemorrhagic polypoid lesion originating 1 cm below the clitoris and completely occupying urethral orifice and partially occluding vaginal vestibule. The patient underwent excision of GCA in the midtrimester using an ultrasonic thermal scalpel (Harmonic Scalpel) without any additional treatment and subsequently delivered a single live healthy baby. The excision of GCA occurring during pregnancy using Harmonic Scalpel can be regarded as a new successful method. Prospective, randomized, and controlled studies are warranted in order to provide clear evidence of the efficiency and safety of HS in the treatment of GCA.

Giant condyloma acuminatum: report of surgical treatment and evolution of healing

Giant condyloma acuminatum: report of surgical treatment and evolution of healing

Buschke-Lowenstein Tumor

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.

Buschke-Lowenstein tumor of the inguinal region: A rare entity in a rarer location

Buschke-Lowenstein tumor (BLT), also known as giant condyloma accuminata, first described in 1896 by Buschke, is a rare, slow-growing, locally invasive, mass lesion commonly affecting the anogenital region in immunocompromised males. This florid type of verrucous carcinoma is known for its high rate of recurrence as well as malignant conversion to squamous cell carcinoma. BLTs have been commonly reported to involve the penis, scrotum, bladder, vulva and perianal or anorectal regions. Our index case remains distinguished on the account of the rare anatomical location, causing a diagnostic dilemma, and once diagnosed managed adequately via surgery alone.

Buschke-Loewenstein Tumor: a case series from Brazil

Buschke-Loewenstein Tumor or giant condyloma acuminatum is a disease caused by a DNA virus, the self-inoculable human papilloma virus (HPV), being sexually transmitted. Histologically BLT is a benign tumor, but with malignant clinical behavior and a high propensity for local recurrence and malignant degeneration. The clinical picture consists of the presence of a cauliflower-like bulky condylomatous perianal mass with multiple fistulous tracts, which can cause great destruction of the anal canal, with invasion of adjacent tissues. Bleeding, foul odor, local pain and weight loss are also described. The diagnosis is established by biopsy, that should exclude the presence of malignant transformation, which occurs in 30–50% of cases. Associated with a biopsy, the hybridization test may be performed to diagnose HPV infection, especially subtypes 6 and 11, that are commonly related. The treatment of choice is radical surgical excision; however, those patients presenting with extensive fistulous lesions may require a temporary colostomy. Some authors advocate an abdominoperineal resection in cases of infiltration of the sphincter or rectum. This study was designed to evaluate the experience of the service of Coloproctology at a referral hospital in Northeastern Brazil with this rare entity, contributing to world literature in addressing this disease.