“Giant Condyloma Acuminatum (Buschke–Lowenstein tumor): Combined treatment with surgery and chemotherapy.”—Further points to be discussed

Gómez, Claudia Juliana Díaz

doi:10.1111/dth.13268

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…There are multiple surgical approaches for BLT resection, which can be seen as alternatives, such as radiofrequency, electrocoagulation, carbon laser, or classical surgery. Complete resection is very important, with reconstruction at the same time or in a delayed manner [ 22 ]. Surgical removal with well-defined secure margins, ensuring a distance of at least 1 cm, and encompassing the subcutaneous fatty tissues with meticulous dissection from the external anal sphincter is very important.…”

Section: Resultsmentioning

confidence: 99%

“…It is considered that this disease, because of its morbidity and the signs and symptoms associated with surgical management, the need for chemotherapy or radiotherapy, and the high rate of recurrence, has a negative influence on patients’ quality of life [ 30 ]. There are a few case reports that emphasize the social stigma caused by BLT and the importance of the psychological and emotional impact on these patients [ 21 , 22 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation

Mihailov,

Tatu,

Niculet

et al. 2023

Life

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Introduction: The Buschke–Löwenstein tumor (BLT) is an uncommon sexually transmitted ailment attributed to the human papillomavirus (HPV)—usually the 6 or 11 type (90%)—with male predominance and an overall infection rate of 0.1%. BLT or giant condyloma acuminatum is recognized as a tumor with localized aggressiveness, displaying distinctive features: the potential for destructive growth, benign histology, a rate of 56% malignant transformation, and a high rate of recurrence after surgical excision. There are several treatment choices which have been tried, including laser, cryotherapy, radiotherapy, electrocoagulation, immunotherapy, imiquimode, sincatechins, intralesional injection of 5-fluoruracil (5-FU), isolated perfusion, and local or systemic chemotherapy. In the case of an extensive tumor, preoperative chemotherapy or radiotherapy is used for tumor shrinkage, making the debulking procedure safer. HPV vaccines significantly decrease the incidence of genital warts, also decreasing the risk of BLT; HPV-6 and HPV-11 are included in these vaccines. Materials and methods: We present a 53-year-old heterosexual man, hospitalized in our department in June 2021 with a typical cauliflower-like tumor mass involving the perianal region, which progressively increased in size for almost 7 years. The perianal mass was completely removed, ensuring negative surgical margins. The large perianal skin defect which occurred was reconstructed with fascio-cutaneous V-Y advancement flap. There was no need for protective stoma. The literature review extended from January 1980 and December 2022, utilizing Pubmed and Google Scholar as search platforms. Results: Due to the disease’s proximity to the anal verge and the limited number of reported cases, arriving at a definitive and satisfactory treatment strategy becomes challenging. The optimal approach entails thorough surgical removal of the lesion, ensuring well-defined surgical margins and performing a wide excision to minimize the likelihood of recurrence. In order to repair the large wound defects, various rotation or advancement flaps can be used, resulting in reduced recovery time and a diminished likelihood of anal stricture or other complications. Our objective is to emphasize the significance of surgical excision in addressing BLT through the presentation of a case involving a substantial perianal condyloma acuminatum, managed successfully with complete surgical removal and the utilization of a V-Y advancement flap technique. In the present case, after 5 months post operation, the patient came back with a buttock abscess, which was incised and drained. After another 5 months, the patient returned for difficult defecation, with an anal stenosis being diagnosed. An anal dilatation and sphincterotomy were carried out, with good postoperative results. Conclusions: The surgical management of Buschke–Löwenstein tumors needs a multidisciplinary team with specialized expertise. The reconstruction techniques involved can be challenging and may introduce additional complications. We consider aggressive surgery, which incorporates reconstructive procedures, as the standard treatment for Buschke–Löwenstein tumors. This approach aims to achieve optimal surgical outcomes and prevent any recurrence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation

Mihailov,

Tatu,

Niculet

et al. 2023

Life

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“…However, there is no standardized selection process to determine the appropriate therapeutic approach. It is advisable to adopt an individualized therapeutic approach for each case[ 19 ]. There are multiple options for surgical treatment to remove GCA, including traditional surgery, as well as alternative methods such as electrocoagulation, radiofrequency, and carbon laser surgery, which is used for intraurethral and common extragenital verrucas.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report

Hsu,

Yu,

et al. 2023

World J Clin Cases

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Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways: Prediction and forecast. Prediction is related to explaining past and current data based on various internal and external influences that may or may not have a causative role. Forecasting is an exploration of the possible future values based on the predictive ability of the model and hypothesized future values of the external and/or internal influences. The time series analysis approach has the advantage of being easier to use (in the cases of more straightforward and linear models such as Auto-Regressive Integrated Moving Average). Still, it is limited in forecasting time, unlike the classical models such as Susceptible-Exposed-Infectious-Removed. Its applicability in forecasting comes from its better accuracy for short-term prediction. In its basic form, it does not assume much theoretical knowledge of the mechanisms of spreading and mutating pathogens or the reaction of people and regulatory structures (governments, companies, etc. ). Instead, it estimates from the data directly. Its predictive ability allows testing hypotheses for different factors that positively or negatively contribute to the pandemic spread; be it school closures, emerging variants, etc. It can be used in mortality or hospital risk estimation from new cases, seroprevalence studies, assessing properties of emerging variants, and estimating excess mortality and its relationship with a pandemic.

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“…The gold standard for the treatment of CAG is resection with free margins; however, multiple treatment combinations are described together with surgery both in a neoadjuvant and adjuvant way with different results [ 6 ] and without a clear indication of a criterion standardized selection process for the therapeutic approach. A personalized therapeutic approach is recommended in each case [ 28 ].…”

Section: Clinical Managementmentioning

confidence: 99%

“…Li et al mentioned in their case report that the signs associated with GCA caused social stigma [ 18 ]. And other case reports emphasize the importance that should be given to the emotional sphere [ 6 , 28 ].…”

Section: Clinical Evolutionmentioning

confidence: 99%

Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage

Condoy

Acuña-Pinzón

Chavarría-Chavira

et al. 2021

Infectious Diseases in Obstetrics and Gynecology

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Giant condyloma acuminatum (GCA) or Buschke-Loewenstein tumor is a rare disease, with an estimated prevalence of 0.1%. It was initially described in 1896 by Buschke and later in 1925 by Buschke and Loewenstein. Classic condyloma acuminata (CCA) and squamous cell carcinoma (SCC) were initially described as different entities. These three entities are currently considered to correspond to the same spectrum of different but not exclusive malignant transformations, associated with multiple risk factors such infection by human papilloma virus (HPV), immunodeficiencies, poor hygiene, multiple sexual partners, and chronic genital infections. HPV subtypes 6 and 11 are associated with 90% of GCA. It presents as a cauliflower-like tumor in the genital region with bad odor, bleeding, and local infection, differential diagnosis with multiple conditions should be considered, and sexually transmitted diseases should always be investigated. GCA has a higher rate of malignant transformation than CCA and tends to infiltrate adjacent soft tissues. The therapeutic approach is controversial but is considered that the resection with free edges is the gold standard and can be combined with adjuncts. The recurrence rate is high. Overall mortality is 21% and is associated with morbidity caused by recurrences. Imiquimod cream 5% has recently shown good results as monotherapy and in combination with ablative and surgical treatments. The quality of life is diminished in patients with this condition. In this review, we address the different aspects of this rare entity including the therapeutic approach.

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“Giant Condyloma Acuminatum (Buschke–Lowenstein tumor): Combined treatment with surgery and chemotherapy.”—Further points to be discussed

Cited by 3 publications

References 3 publications

Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation

Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation

Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report

Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage

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