Buschke-Löwenstein Tumor (BLT): Successful Treatment of Human Papillomavirus (HPV)-Associated Squamous Cell Carcinoma With Radical Surgery and Chemotherapy

Abstract

The giant condyloma acuminatum, known as the Buschke-Löwenstein tumor (BLT), is an uncommon, slow-growing, cauliflower-like tumor located in the anogenital region. It has a high recurrence rate, is sexually transmitted, and is often linked with immunosuppression. This tumor is commonly associated with human papillomavirus (HPV) infection, making HPV one of the most prevalent sexually transmitted infections affecting the perineal and genital regions. Treatment options primarily involve a combination of surgical excision and adjuvant chemotherapy. In this report, we present the case of a 63-year-old heterosexual, HIV-negative female patient whose locally advanced disease severely impacted her quality of life due to multiple bilateral perianal fistulas and the development of squamous cell carcinoma. The patient also struggled with chronic anemia resulting from recurrent hemorrhages. She underwent a Miles procedure, consisting of an extralevator abdominoperineal excision with terminal colostomy. Following adjuvant chemotherapy, she achieved complete wound healing by secondary intention, with no complications or signs of wart recurrence. This report highlights that surgical resection, complemented by adjuvant therapy, can lead to excellent outcomes even in advanced cases with local progression, regional spread, and malignant transformation, without requiring additional reconstructive surgery or skin grafting, thus facilitating recovery.