Case report: Buschke-Lowenstein tumor, a giant anal condyloma acuminata.

24-year-old man with positive HIV, with a giant exofitic anal condyloma, with a clinical presentation of a painfull suppurative anal condyloma with a pathology report of an in situ squamous cell carcinoma. The purpose of the investigation is a case report and the procedure was observational. The finding was a Buschke-Lowenstein tumor.

Varón de 24 años, con infección por el virus de la inmunodeficiencia humana, que presenta una tumoración exofítica, dolorosa y supurativa, con reporte positivo de virus de papiloma humano y reporte histopatológico de carcinoma espinocelular sin evidencia de diseminación (in situ). El propósito de la investigación es un reporte de caso y el procedimientos fue observacional. El hallazgo fue un tumor de Buschke-Lowenstein.

Giant condyloma acuminatum (Buschke-Lowenstein tumour) of the vagina during pregnancy.

A primiparous woman in her mid-30s presented at 31 weeks of gestation with a large vaginal mass obstructing the cervix, initially concerning for malignancy. Pelvic MRI confirmed a vaginal lesion located on the lateral wall, and histopathology diagnosed a giant condyloma acuminatum. The vaginal lesion was surgically resected at 34 weeks of gestation, and the patient proceeded to have a successful vaginal birth. Our case report demonstrates an unusual presentation of a rare anogenital disease and highlights a differential diagnosis for cervical and vaginal lesions.

"Free-Floating Anus": A Flap-Free Approach for Definitive Excision of Circumferential Giant Condyloma Acuminata.

Giant condyloma acuminata (GCA), or Buschke-Löwenstein tumor, is a rare exophytic cauliflower-like growth in the anogenital region. The spectrum of treatment options is wide, ranging from the application of topical ointments to the performance of an abdominoperineal resection. Currently, wide local excision is the most common approach and may entail the creation of a protective loop ileostomy or implementation of flaps or grafts that facilitate closure. We describe a unique surgical approach for the management of circumferential GCA void of the use a protective loop ileostomy, flaps, or grafts. Our report highlights that the implementation of a radical, circumferential, wide excision resulting in "free-floating anus" and healing via secondary intention can ultimately lead to excellent functional and cosmetic results and therefore may be considered a minimally invasive surgical option for patients afflicted with a large, circumferential GCA.

Squamous Cell Carcinoma of perineal area developed from the Buschke-Löwenstein tumor.

The Buschke-Löwenstein tumor is a rare disease associated with human papillomavirus infection. The condition manifests with an ulcerative, exophytic tumor localized in the perineal area. Generally considered as non-cancerous, the growth may develop malignant transformation. Our manuscript highlights the importance of early diagnosis with histopathological analysis.

Vulvar Buschke-Löwenstein tumor in a HPV 16 infected woman: case report.

The Buschke-Löwenstein tumor is characterized by an exophytic lesion on the perianal region. It is considered benign but there is a high risk of recurrence and degenerative potential. It is commonly associated with human papillomavirus (HPV) especially subtypes 6 and 11, its evolution depends on the host's immunity and the association with other sexually transmitted diseases. Surgical excision is the recommended treatment in most cases. We report the case of a 54-year-old woman with only diabetes history, who had verrucous vulvar lesion associated to HPV subtype 16 treated with large excision.

The Pathogenesis of Giant Condyloma Acuminatum (Buschke-Lowenstein Tumor): An Overview.

Giant condyloma acuminatum, also known as Buschke-Lowenstein tumor (BLT), is a rare disease of the anogenital region. BLT is considered a locally aggressive tumor of benign histological appearance, but with the potential for destructive growth and high recurrence rates. BLT development is strongly associated with infection with low-risk human papillomaviruses (HPVs), mostly HPV-6 and -11. Immunity to HPVs plays a crucial role in the natural control of various HPV-induced lesions. Large condyloma acuminata are frequently reported in patients with primary (e.g., DOCK8 or SPINK5 deficiencies) and secondary (e.g., AIDS, solid organ transplantation) immune defects. Individuals with extensive anogenital warts, including BLT in particular, should therefore be tested for inherited or acquired immunodeficiency. Research into the genetic basis of unexplained cases is warranted. An understanding of the etiology of BLT would lead to improvements in its management. This review focuses on the role of underlying HPV infections, and human genetic and immunological determinants of BLT.

Giant anogenital tumor of Buschke-Löwenstein in a patient living with human immunodeficiency virus/acquired immunodeficiency syndrome: a case report.

BACKGROUND: Buschke-Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke-Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients. CASE PRESENTATION: We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ''butterfly wing'' structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm3) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke-Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection. CONCLUSION: Buschke-Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.

Clinical Conundrum: A Case of Cervical Giant Condyloma Acuminatum.

Giant condyloma acuminatum (GCA) is a benign anogenital lesion caused by human papilloma virus. It is rarely found on the cervix and is difficult to differentiate from malignancy. It is associated with a propensity for invasion, recurrence, and malignant transformation. A 35-year-old woman presented with abnormal uterine bleeding and a suspicious cervical mass. After a Pap test revealed high-grade squamous intraepithelial lesion, cervical biopsies revealed cervical dysplasia. A diagnostic loop electrical excision procedure identified a giant condyloma. A total hysterectomy was performed, confirming the diagnosis. This condition should be in the differential diagnosis for a cervical mass suspicious for malignancy. Prompt biopsy of mass is crucial.

[Giant condyloma acuminatum in pregnancy]. / La tumeur de Buschke Lowenstein chez la femme enceinte.

Buschke Lownestein's tumour is a giant acuminate condyloma characterised by its degenerative potential, its invasive nature and its recurrence after treatment. It is a rare condition, transmitted mainly by sexual transmission and induced by to the human papillomavirus (HPV). The discussion will be illustrated by a clinical case The treatment is still under discussion but surgery seems to be the best option. Management during pregnancy is more complex since it must take into account the mother and her fetus. The delivery route is still debated. The post-treatment evolution was satisfactory and without recurrence until the delivery which, due to the antecedent of 3 caesarean sections, was carried out by cesarean section. HPV vaccination, sex education and early treatment of condyloma lesions should prevent and in any case improve the prognosis of this disease.

A rare case of self-healing giant condyloma acuminatum.

Giant condyloma acuminatum (GCA) which is also called Buschke-Lowenstein tumor. It is a rare tumor of the anorectal area and external genitalia associated with low-risk HPV types 6 or 11. GCA has a high-rate of recurrence (66%) and malignant transformation (56%). The clinical features of GCA are progression of exophytic, ulcerative, and cauliflower-shaped tumors, it has significant dimensions and may undergo malignant transformation such as squamous cell carcinoma or cervical cancer. It is difficult to treat GCA, and it may be impossible for GCA to self-healing, but we herein report a rare case of a 19-year-old female with self-healing GCA.

Recurrent fungating tumor and a chronic rash in an immunosuppressed transgender patient: a case of Buschke-Lowenstein condyloma and epidermodysplasia verruciformis.

A transgender female in her 40s with history of HIV and testicular cancer status post-genital X-irradiation presented with a perianal mass and pruritic rash across her chest. Physical examination revealed a bulky, verrucous tumor protruding outward from the anus involving the medial buttocks. Examination of the chest and arms showed numerous guttate, pink, flat-topped papules coalescing into plaques. Clinically and histologically the lesions were consistent with Buschke-Löwenstein condyloma (BLC) and acquired epidermodysplasia verruciformis (AEDV). Buschke-Löwenstein condyloma incisional biopsy tested negative for common low- and high-risk human papillomavirus (HPV) subtypes, including 6, 11, 16, and 18, possibly implicating beta HPV subtype or a less common pathogenic subtype. The patient underwent abdominoperineal resection of the BLC, which tested positive for low-risk HPV subtypes, suggesting the possibility of multiple implicated HPV subtypes in the same tumor. This case demonstrates a possible role of beta HPV or rarer HPV subtypes in the pathogenesis of verrucous carcinoma, particularly in the setting of immunosuppression.

Löwenstein-Buschke: Clinicopathologic Analysis of 78 Cases of Large and Giant Condyloma Acuminata of the Anus.

OBJECTIVE: The nature and clinicopathologic associations of Löwenstein-Buschke disease are unclear. MATERIALS AND METHODS: 78 anal condylomatous lesions (≥2 cm) were analyzed. Cases were classified based on size as "medium-large"(2-5 cm, n=59), "large" (5-10 cm, n=13) and "giant" ( > 10 cm, n=6). RESULTS: Patients were predominantly males (male/female=70/8). The mean age was 38 years (range:20-66). Two distinct lining types were recognized: 1) Epidermal type, typically lacking overt koilocytotic change, with associated invasive carcinoma in 8%; 2) Mucosal type, often manifesting koilocytotic change, with associated invasive carcinoma in 21%. Three types of high-grade dysplasia were discerned: 1) Basaloid, 8/9 showing high-grade dysplasia/carcinoma in-situ but non-invasive lesions; 2) Keratinizing, innocuous-appearing, but 5/6 was associated with invasion; 3) Giant cell, showing scattered individual bizarre cells, with 3/5 showing invasive carcinoma. Overall, invasion was found in 14% of the cases. The bulbous, broad-based destructive pattern characterizing verrucous carcinomas of the upper aerodigestive tract was not observed. A statistically significant trend existed between the incidence of invasion and size: 8.5% for medium-large, 23% for large, and 50% for giant (p=0.02). There was no discernable trend in the depth of invasion relative to condyloma size. CONCLUSIONS: Our findings suggest that Löwenstein-Buschke lesions are mega versions of conventional condyloma. Being verrucoid, large and minimally invasive, they can be conceptually regarded as a form of verrucous carcinoma, but they do not display the histologic characteristics of verrucous carcinoma defined in the aerodigestive tract. They exhibit two types of linings: the mucosal type that often shows koilocytotic changes, and the epidermal type that can be difficult to recognize in biopsies. These lesions may be associated with invasive carcinoma, albeit limited in amount.

Buschke-Lowenstein tumor in a patient with HIV and Psoriasis / Tumor de Buschke-Lowenstein em um paciente com HIV e psoríase

Abstract The Buschke-Lowenstein tumor, known as the giant condyloma acuminatum, is a rare lesion of the anorectal and PerianaL region; it is sexually transmitted and associated with human papilloma virus, types 6 and 11. Histologically, it is a benign tumor, but it can reach big proportions and may behave aggressively. The purpose of this study is to report the case of a patient diagnosed with HIV and psoriasis 14 years ago, associated with Buschke-Lowenstein tumor and other diffuse condylomatous lesions in the body.

Resumo O tumor de Buschke-Lowenstein, também conhecido como condiloma acuminado gigante, é uma lesão rara da região anorretal e perianal, sexualmente transmitida, associada ao papiloma vírus humano, Tipos 6 e 11. Histologicamente, trata-se de um tumor benigno, mas clinicamente atinge grandes proporções e pode se comportar de forma agressiva. O objetivo deste estudo é relatar o caso de um paciente com diagnóstico de HIV e psoríase há 14 anos, associado ao tumor de Buschke-Lowenstein e outras lesões condilomatosas difusas no corpo.

Giant condyloma acuminatum (Buschke-Lowenstein tumor): Combined treatment with surgery and chemotherapy.

We present a case of giant condyloma acuminatum (Buschke-Lowestein tumor) managed with combined treatment of surgery of chemotherapy.

Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases.

Buschke-Löwenstein tumor (BLT) is a rare sexually transmitted disease, mostly described in clinical literature as case reports or small series. Here, we investigated the clinicopathologic features of BLT in a total of 38 cases retrieved from multiple academic institutions. The average age was 47.6 ± 12.8 (mean ± SD) years old at diagnosis. The male to female ratio was 4.4:1. Common presenting symptoms were pain/discomfort, bleeding, mass lesion, and discharge. It was frequently linked to smoking and positive human immunodeficiency virus status. The tumor size and thickness were 8.5 ± 6.6 cm and 1.5 ± 1.3 cm, respectively. Histologically, 19 (50%) cases had an invasive squamous cell carcinoma component and were associated with high-risk human papillomavirus infection. There was no lymphovascular or perineural invasion, or nodal metastasis at initial diagnosis. BLTs with invasion had higher frequency of dyskeratosis, neutrophilic microabscesses, and abnormal mitoses, but lower frequency of pushing border compared with BLTs without invasion. All patients underwent wide excision, and some also received chemoradiation therapy. After a median follow-up of 23 months (range 1-207), the recurrence rate was 23.7% and disease-specific mortality was 2.6%. In summary, we presented the largest case series of BLT to date to characterize its unique clinicopathologic features. Our study indicated that certain histologic features such as dyskeratosis, neutrophilic microabscess, and abnormal mitosis in the non-invasive portion may be important clues on lesional biopsy to predict the presence of underlying invasive carcinoma.

Giant perianal condyloma acuminatum in an infant without sexual abuse.

Giant condyloma acuminatum is rare in infants. We report a case of giant perianal condyloma in a 10-month-old infant without sexual abuse. The patient was treated by surgical excision associated with electrocoagulation with no recurrence after 2 years. While both sexual and nonsexual transmissions are possible in patients with condyloma acuminatum, sexual abuse must always be considered in children.