Human Papillomavirus Type 6 Associated Buschke‐Loewenstein Tumor (Giant Condyloma Acuminatum)

Abstract

The term "Buschke-Loewenstein tumor" has been used for tumors with exophytic, wart-like excrescences in the anogenital region. This broadly includes giant condyloma acuminatum and verrucous carcinoma. We report a 44-year-old Japanese man with a giant condyloma acuminatum Buschke-Loewenstein tumor on the right femoinguinal area. The lesion was a huge grape-like nodule composed of multiple small nodules, reaching 135 x 65 x 40 mm in size. Histologically, it showed a regularly acanthotic papilloma with numerous koilocytes in the upper squamous and granular layers. Ultrastructural findings included gradual differentiation from basal cell layers to uppermost corneocytes without disorganized relationships in the epithelial-stromal junction or cellular atypia. Human papillomavirus type 6 DNA was detected in the tumor tissues by polymerase chain reaction and restriction enzyme analysis, although immunohistochemical staining for papillomavirus common antigen was negative.

Large Anogenital Carcinoma Associated with Human Papilloma Viruses

“…EV patients develop flat warts and other skin lesions in the first decades of life, and these skin lesions degenerate to squamous cell carcinoma in the second and third decades of their lives 9 . Detection of HPV-5 in EV cancers provided the scientific evidence of HPV in human carcinogenesis 4,9 . Furthermore, EV patients carry genetic mutations of the EVER1 (TMC6) or EVER2 (TMC8) genes which are located adjacent to one another on chromosome 17, and EV patients showed various degrees of immunodeficiency 10 .…”

“…Most of the anogenital papilloma/condylomas are small and associated with HPV type 6 and 11 with low to minimal neoplastic potential (low-risk HPV) 1, 4,5 . A small percentage of these skin lesions are associated with HPV type 16 and 18 with high risk neoplastic potential (high risk HPV), similar to cervical intraepithelial lesions 2,6 .…”

Vulva and Vagina

“…60 Both lesions characteristically contain a low-risk HPV genome, 61,62 display condylomatous features at least focally, and behave in a similar fashion. 60 Both lesions characteristically contain a low-risk HPV genome, 61,62 display condylomatous features at least focally, and behave in a similar fashion.…”

Treatment of genital warts — what's the evidence?

“…Very occasionally they can form Buschke± Lo È wenstein giant condyloma, a locally invasive, but non-metastasizing tumour 8 . Vertical transmission can occur, but in view of the high prevalence of HPV-6 and 11 in women of childbearing age and the infrequency of laryngeal and genital warts in infants, it is rare 9 .…”