Management of peri-anal giant condyloma acuminatum—A case report and literature review

Abstract

Giant condyloma acuminatum (GCA), originally described by Buschke and Loewenstein in 1925 as a lesion of the penis, is more rarely seen in the anorectum and is characterized by clinical malignancy in the face of histologic benignity; however, malignant transformation to frankly invasive squamous-cell carcinoma has been described in about one-third of patients. In addition, malignant transformation has been reported in patients with "ordinary" condylomata acuminata. Human papillomavirus, known to cause condylomata acuminata, is also known to induce these tumors and was found in 96% of 63 cases reviewed in the last 10 years. These lesions have a propensity for recurrence and a likelihood of malignant transformation, and lead to significant mortality. Therefore, early and radical R0 excision, along with vigilant follow-up, provides the hope for cure. Conservative and/or multimodal therapy has been reported in a few cases, but its effect is not yet proved. The authors report one case of GCA; in addition, they reviewed the literature over the last 10 years and compared with previous reviews.

Large Anogenital Carcinoma Associated with Human Papilloma Viruses

“…Anogenital verrucous carcinoma, also known as the Buschke-Lowënstein tumor, was first described by these two men in 1925 7 . Verrucous carcinoma is a locally aggressive, slowgrowing, well differentiated squamous cell carcinoma with minimal metastatic potential 2 .…”

“…Treatment of choice is considered wide surgical excision. Surgery alone has resulted in a disease-free status in 45.5% of patients 7 . Controlled trials comparing treatments are lacking, but oral and topical chemotherapeutic modalities have been used as adjuvant to surgery.…”

“…Cases have been reported of locally aggressive behavior that has penetrated into fascia, and bone. Anogenital subtype has the potential to ulcerate and form fistulae and sinuses; recurrence is common 7 . With the incidence in the United States and worldwide unknown, reports show this tumor predominantly affects Caucasian males in their middle age and the immunocompromised.…”

Effective management of extensive tissue loss after abdominoperineal resection for Buschke-Loewenstein tumor

“…But even the surgical approach whether or not making a diverting stoma, and the way of closing the large defect of the perineum after the surgical excision, is not standardized. Pre-operative pelvic RMN is essential for the evaluation of the size, extent of the tumor and the infiltration of surrounding tissues (8). The role of the preoperative biopsy is limited due to the heterogeneity of the histological changes within the large tumor.…”

Giant fibroepithelial polyp of the glans penis not associated with condom-catheter Use: A case report and literature review

“…Giant condylomas are HPV-driven lesions and are known to undergo malignant transformation to squamous cell carcinoma. 17 A tissue biopsy would identify typical features of squamous cell carcinoma.…”