Radiation-induced total regression of a highly recurrent giant perianal condyloma

Abstract

We report a case of a highly recurrent giant perianal condyloma, or Buschke-Lowenstein tumor, which was successfully treated by telecobalt therapy. We conclude that radiation therapy is an optional treatment modality for the management of giant perianal condylomata in selected cases.

Wide local excision for Buschke-Löwenstein tumor or circumferential carcinoma in situ

“…Due to the rarity of this condition, there is no consensus as to the ideal treatment modality. Data available in the literature is mostly derived from case reports [4][5][6][7][18][19][20][21][22]. Surgical options vary from local excision to abdominoperineal resection [5,6].…”

“…Treatment for anal warts includes fulguration and excision, cryotherapy, and application of ointments such as podophyllin and imiquimod 5%. However, there is little guidance as to the optimal management of Buschke-Löwenstein tumor because of its rarity [4][5][6][7][13][14][15][16][17][18][19][20][21][22]. Furthermore, the management of AIN is evolving without widely accepted standard of care [1,[8][9][10][11][12][13][23][24][25][26][27][28][29][30][31].…”

“…And while numerous management options are available to treat such disorders, significant challenges remain in terms of disease recurrence or morbidity of treatment. Furthermore, no standardization of care exists for anal disease such as extensive carcinoma in situ or rare neoplasms such as Buschke-Löwenstein tumor [1,[4][5][6][7][8][9][10][11][12]. The purpose of this study was to review a single-center experience with wide local excision and flap or skin graft wound coverage for patients with Buschke-Löwenstein tumor or extensive circumferential anal carcinoma in situ.…”

Should the Surgical Management of Buschke-Lowenstein Tumors Be Aggressive? About 10 Cases

“…Some teams proposed the use of CO 2 laser in addition to surgical excision [6,8] . Radiation therapy has been described as an effective treatment of recurrence [5,12] but is still controversial because of the inducted malignant transformation risk and has not demonstrated its effectiveness on primary lesions [6,8,12,13,21] . Some systemic or local chemotherapy (5-fluorouracil) were used without conclusive results [4,12,13] .…”

Surgical Management of Perianal Giant Condyloma Acuminatum (Buschke-Löwenstein Tumor)

“…The use of radiotherapy is still controversial, because of the evidence of anaplastic transformation and extensive appearance of new condylomas after its use, and because of the lack of long-term results [19][20][21] . The role of systemic chemotherapy is not well defined because of paucity of data, and also topical chemotherapy with 5-fluorouracil seems to give poor results in the case of GCA [7] .…”