Successful application of aminolevulinic acid/photodynamic therapy in the treatment of giant condyloma acuminatum in an 87-year-old patient.

Condyloma acuminatum is a common sexually transmitted disease caused by human papillomavirus infection and is a benign hyperplastic lesion of the genital and perianal areas. The principle of its treatment is to remove the visible warts as much as possible and to prevent recurrence. Traditional treatment methods of condyloma acuminatum, such as CO2 laser, liquid nitrogen freezing, surgery, and topical medications, can remove warts. However, these methods have disadvantages such as pain, high recurrence rates, long treatment cycles, and scarring. Aminolevulinic acid/photodynamic therapy (ALA-PDT), a safe and effective method, has been widely used to treat condyloma acuminatum in recent years. Condyloma acuminatum occurs relatively rarely in elderly patients, in whom treatment is difficult owing to poorer physiological function. We successfully treated an 87-year-old patient with a giant condyloma acuminatum of the glans penis using six sessions of ALA-PDT at 7-day intervals and obtained satisfactory results. No recurrence was observed during a 6-month follow-up. Therefore, ALA-PDT is worth popularizing in clinical practice.

Modified photodynamic therapy of vulvar giant condyloma acuminatum complicated by systemic lupus erythematosus: A case report.

Giant condyloma acuminatum (GCA) is a rare disease characterized by cauliflower-like tumors in the genital area, with a peculiar smell, bleeding, and local infection. Its occurrence is related to a variety of risk factors, such as human papillomavirus infection, immune deficiency, poor sanitary conditions, multiple sexual partners, and chronic genital infection. Surgical resection is still the preferred treatment for the disease. This paper reports that a patient with GCA complicated by systemic lupus erythematosus (SLE) and persistent thrombocytopenia who could not be treated surgically was treated with modified photodynamic therapy (M-PDT) in our outpatient department. After several treatments, the pain, odor, and secretion on the surface of the wart were significantly reduced, although the size of the wart was not significantly improved. Unfortunately, the patient died subsequently due to the aggravation of SLE. However, clinical treatment with M-PDT may be used as a palliative treatment when similar patients are encountered.

Successful management of giant condyloma acuminatum of vulva with the combination of surgery and photodynamic therapy: Report of two cases.

Patients with condylomata acuminata of the vulva usually have increased difficulty to achieve complete response to treatment and also have a higher risk for disease recurrence. Treatment for this disease varies, including surgical excision, cryotherapy, electrocautery, CO2 laser therapy, topical therapy, and photodynamic therapy (PDT), but none of these alone provides a satisfactory outcome, especially for giant condyloma acuminatum (GCA). We reported two cases of GCA successfully cured with surgical removal, electrocautery and photodynamic therapy.

Buschke - Lowenstein anal tumor: an ambiguous entity.

The Buschke - Lowenstein tumor is a rare sexually transmitted disease. Its location at the anal margin is also very rare. The most incriminated risk factor is human papillomavirus infection. Its clinical form may be confusing with other tumor and infectious lesions. Histologically, it is characterized by a well-differentiated malpighian proliferation. It represents local aggressive behavior. The treatment of reference remains the surgery with healthy margins of excision. Other treatments have been tested, but their effectiveness remains uncertain. We report here a new case of anal margin Buschke - Lowenstein tumor with a review of the literature.

Successful treatment of giant condyloma in a pediatric heart transplant recipient with topical cidofovir.

We report a case of giant condyloma that developed in a pediatric heart transplant recipient. This infection progressed for several months despite reduction in immunosuppression, topical treatment, and oral cimetidine therapy. Complete resolution was observed following 7 months of topical cidofovir, without evidence of systemic toxicity or rejection.

Tumor de Buschke-Löwenstein. presentación de un caso / Tumor de Buschke-Löwenstein. apresentação de um caso / uschke-Löwenstein tumor. case report

Se presentó un paciente masculino de 68 años, que acudió a consulta de Dermatología por presentar lesiones vegetantes en coliflor en región inguinal izquierda, pubis y perineales, de 10 años de evolución y nunca tratadas. El tumor de Buschke-Löwenstein o condiloma acuminado gigante es una tumoración epitelial benigna, causada por el virus del papiloma humano, trasmisible sexualmente, en raros casos puede malignizar. Se realizó escisión quirúrgica y estudio histopatológico de la lesión inguinal, las restantes lesiones fueron eliminadas con ácido tricloroacético, tratamiento tópico, logrando regresión total de las mismas y se le administró levamisol, inmunomodulador sistémico. La evolución posquirúrgica fue satisfactoria(AU)

A male patient of 68 years was presented who consulted Dermatology to present vegetating and cauliflower lesions in the left inguinal, pubic and perineal region, 10 years of evolution and never treated. Tumor of Buschke-Löwensteinor giant condyloma is a benign epithelial tumor is caused by the human papillomavirus, sexually transmitted and in rare cases can become it in malignant. Surgical excision and histopathological examination of the inguinal lesion was done, the remaining lesions were removed with trichloroacetic acid, topical treatment, achieving complete regression thereof and administered levamisole and systemic immunomodulator. The postoperative course was satisfactory(AU)

Paciente do sexo masculino, 68 anos, apresentou-se aoServiço de Dermatologiadevido a lesões vegetantes nacouve-flor naregião inguinal esquerda, púbis e períneo, comduração de 10 anose nunca tratadas. O tumor de Buschke-Löwenstein ou o condiloma acuminado gigante é um tumor epitelial benigno, causado pelo papilomavírus humano sexualmente transmissível, podendo, em casos raros, malignizar. Excisãocirúrgica e estudo histopatológico da lesão inguinal foram realizados, as lesõ es remanescentesforam eliminadas com ácido tricloroacético, tratamento tópico, obtendoregressão total das mesmas e foi administrado levamisol, imunomodulador sistêmico. A evoluçãopós-operatória foi satisfatória(AU)

Successful improvement of Buschke-Löwenstein tumour in an HIV-infected patient with antiretroviral therapy alone.

Buschke-Löwenstein tumour (BLT), also defined as giant condyloma acuminatum, is a rare exophytic tumour affecting the anogenital and perianal regions associated with human papillomavirus (HPV) infections, with a potential of malignant transformation and which is at a greater risk in T-cell mediated immunodeficient patients. Different therapeutic options, alone or in combination, have been reported for the treatment of BLT including local therapy but wide surgical local excision is however recommended as the most important therapeutic intervention. We report a case of a HIV-infected man who developed a voluminous pelvic BLT which disappeared progressively under antiretroviral therapy with no additional treatment, contemporary to an improvement of his immunity, highlighting the possible spontaneous reversibility of HPV-induced tumours in treated HIV infection.

Successful treatment with topical imiquimod of anal Buschke-Löwenstein tumor in a child.

Buschke-Lowenstein tumor (BLT) is a large exophytic lesion of the anogenital region with a clinically malignant aspect but a benign histology. Because of its low incidence, this pathology is exceptional in childhood. Surgical excision is the main therapeutic approach. Herein, we report a case of BLT successfully treated with imiquimod in a 2-year old boy. Young children with BLT should be offered a chance of medical treatment before extensive surgical destruction is used.

Buschke-Löwenstein tumor: squamous cell carcinoma of the anogenital region.

INTRODUCTION: Buschke-Löwenstein tumor (BLT), as a rare form of condylomata acuminatum, was firstly described by Buschke in 1886 as a "carcinoma-like condyloma acuminatum of the penis". BLT is generally considered to be a low-grade variant of squamous cell carcinoma of the anogenital region. CASE OUTLINE: We describe a case of BLT in a 56-year-old male patient who was referred to our institute due to a large defect in the gluteal region. The biopsy of the lesion was performed and the diagnosis of BLT was made on histopathological examination. Magnetic resonance imaging of the pelvis showed the extensive vegetant lesion that significantly infiltrated pelvic organs accompanied with an enlargement of para-iliac lymph nodes. Sygmoidostomy for fecal diversion was done and chemotherapy with 5-fluorouracil and cisplatin was initiated. Unfortunately, the patient's severe condition caused fatal outcome. CONCLUSION: Our case points out that BLT should be treated at the initial stage in order to prevent untreatable condition which happened in our patient. Therefore, early diagnostics and staging of the disease using modern technologies are crucial in order to treat patients effectively.

Buschke-Löwenstein tumor with squamous cell carcinoma treated with chemo-radiation therapy and local surgical excision: report of three cases.

Treatment of anorectal Buschke-Löwenstein tumor (BLT) with squamous cell carcinoma (SCC) transformation is not univocal given the rarity of the disease. BLT is characterized by its large size and tendency to infiltrate into underlying tissues. Malignant transformation can occur and it is important to identify the presence of neoplastic foci to decide the proper treatment. Our aim was to assess the effectiveness of neo-adjuvant chemo-radiation therapy (CRT) and local excision in order to avoid abdomino-perineal resection (APR). Three cases of anorectal BLT with SCC transformation are presented. All patients were HIV positive and treated with antiretroviral drugs. They underwent preoperative endoanal ultrasound, biopsies, total body tomography and anal brushing. Treatment consisted of neo-adjuvant chemo-radiation therapy (45 Gy to the pelvis plus a boost with 14.40 Gy to the primary tumor for a total of 59.40 Gy, and mitomycin-C in bolus on the first day, plus 5-fluorouracil by continuous infusion in the first and in the sixth week) and subsequent local surgical excision. During the follow-up, patients were subjected to the same preoperative diagnostic investigations and high resolution anoscopy. All patients showed a complete regression of the lesion after CRT and were treated by local surgical excision, thus avoiding permanent colostomy. In conclusion neo-adjuvant chemo-radiation therapy with local surgical excision could be considered an effective therapy in the treatment of anorectal BLT with SCC transformation to avoid APR.

Acute urinary retention in elderly female patients after photodynamic therapy of urethral condyloma--report of two cases.

We report two cases of acute urinary retention (AUR) occurred after intra-urethral aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in elderly females (>66 years old) with urethral condylomas.

Successful treatment of giant condyloma acuminatum with combination retinoid and interferon-γ therapy.

Giant condyloma acuminatum, or Buschke-Löwenstein tumour, is a unique variant of anogenital warts. It is characterized by locally aggressive behaviour but rarely metastasizes. Many treatment strategies such as radical surgery, radiation and chemotherapy have been used to treat it but their efficacy is often poor and the recurrence rates are high. We report a case of 16-year-old girl who was treated with oral retinoid combined with intramuscular interferon-γ. All lesions cleared within three months. During a follow-up period of more than two years, no recurrence has developed. This relatively painless, non-scarring treatment may represent a novel therapeutic option.