Radical Excision and Mesh-Skin Grafting for Giant Anorectal Condyloma Acuminatum

Giant condyloma acuminata of Buschke-Löwenstein: successful treatment with a combination of surgical excision, oral acitretin and topical imiquimod

“…Treatment options for GCA may be roughly categorized as surgical and nonsurgical methods. An initial surgical approach is recommended for complete elimination of the tumour and prevention of recurrence 1–4,7–9 . The extent of surgical excision is determined by the size of the lesion and the degree of penetration to adjacent structures 8 .…”

“…Nonsurgical treatments are claimed to increase recurrence rates due to insufficient tumour destruction and are usually used to shrink the tumour before surgery 1,5,7,8 . Topical podophyllin 25–30% or 5‐fluororacil (5‐FU) are futile in eradicating GCA 1,2,4,7,8 . Although successful preliminary reports of HPV vaccination have brought optimism for the future, immunotherapy still remains an investigational therapeutic tool 1,10 .…”

“…Intralesional or systemic interferon‐α2b may be effective in GCA because of its immunomodulating, antiproliferative and antiviral properties 1,3,5 . Radiotherapy should be reserved for nonresectable or adamantly recurrent lesions, as it may increase the risk of anaplastic transformation 2,4,9 . Systemic chemotherapy with methotrexate, 5‐FU, bleomycin, mitomycin C, cisplatin, and leucovorin may be tried in extensive or recurrent GCA 3,4,9 .…”

“…In addition, GCA has a high propensity for local recurrence and considerable risk of neoplastic transformation into fully invasive squamous cell carcinoma (SCC) 5 . Management is still a challenge; 1 response is often poor, and regardless of the type of treatment, recurrence rates as high as 67% and mortality rates of 20–30% have been reported 1–3 …”

Surgical Management of Giant Condyloma Acuminatum (Buschke-Loewenstein Tumor) of the Perianal Region

“…Wide local excision as an initial mode of treatment is preferred instead of simple excision in most reports for the treatment of GCA 5,7,17–34 . In the majority of these studies, a single case was reported, 5,7,17–29 whereas two, 30 three, 31 six, 32,33 and a maximum of eight 34 patients have been recorded.…”