Giant anorectal condyloma acuminatum of Buschke–Löwenstein presents difficult management decisions

Abstract

Condyloma acuminata, or anogenital warts, caused by human papillomavirus are the most common sexually transmitted disease. In rare cases, the disease could progress to an extensive neoplasm called Buschke–Löwenstein tumor (BLT), also known as giant condyloma acuminatum. BLT differs from normal condyloma acuminata by presenting with locally invasive growth, lack of spontaneous resolution, tendency for recurrence after treatment and potential for malignant transformation. We examine a BLT case reaching large dimensions in the anorectal region treated with neoadjuvant chemoradiation therapy and surgical excision of residual lesions. Furthermore, continuous follow-up care can help identify and prevent recurrence or malignant transformation of the tumor.

Buschke-Lowenstein tumor in a patient with HIV and Psoriasis

“…Patients commonly experience pain, itching, bleeding, and anal mass growth. 1 BLT is a rare variant of genital warts, caused by HPV types 6 and 11 and, occasionally, types 16 and 18. 1 The risk factors described include immunosuppression as a reaction to chemotherapy, corticosteroid therapy, post-transplantation, diabetes mellitus and HIV infection; excessive alcohol consumption; smoking; poor local hygiene; and herpes simplex infection.…”

“…1 BLT is a rare variant of genital warts, caused by HPV types 6 and 11 and, occasionally, types 16 and 18. 1 The risk factors described include immunosuppression as a reaction to chemotherapy, corticosteroid therapy, post-transplantation, diabetes mellitus and HIV infection; excessive alcohol consumption; smoking; poor local hygiene; and herpes simplex infection. 2 As for HIV, in addition to being described as a risk factor for BLT, it appears to be a complex interaction between HIV/HPV and local immune response mechanisms.…”

“…Buschke-Lowenstein Tumor (BLT), also known as Giant Condyloma Acuminatum (GCA), is a rare sexually transmitted anorectal and perianal lesion associated with Human Papilloma Virus (HPV) types 6 and 11. 1 Histologically, it is a benign tumor, but clinically it reaches large proportions and can behave aggressively with extensive tissue infiltration. It usually progresses slowly in immunocompetent patients, but can grow rapidly in immunocompromised individuals.…”

“…It usually progresses slowly in immunocompetent patients, but can grow rapidly in immunocompromised individuals. 1 Although it has no metastatic potential (Santos et al, 2012), in some cases malignant degeneration may occur and therefore early diagnosis and treatment is crucial.…”

A Case of the Giant Buschke — Loewenstein Tumour

“…Однако на представленном примере подтверждено, что малигнизация возможна и при отсутствии иммунодефицита [5]. В анализируемых нами литературных источниках часто описывается аногенитальная область как наиболее типичная локализация ОБЛ [6,7]. Множественное распространение на половые органы делает этот случай особенно редким.…”