Condylomas of the uterine cervix initially interpreted as squamous carcinoma: a report of four cases including a lesion resembling the Buschke-Loewenstein giant condyloma

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.

Verrucous carcinoma of the skin and mucosa

The concept of verrucous carcinoma as a clinicopathologic variant of squamous cell carcinoma is worthy of recognition. It is known by a confusing array of names, such as Ackerman's tumor, Buschke-Loewenstein tumor, florid oral papillomatosis, epithelioma cuniculatum, carcinoma cuniculatum, and cutis papillomatosis carcinoides of Gottron. Its apparent clinical benignity may lead to lengthy periods of misdiagnosis, during which it is likely not to spread to distant lymph nodes, but rather to destroy a nose, mandible, or penis as it slowly but relentlessly extends into underlying tissue. Morphologically warty or verrucous, its relatively bland histologic features are often more suggestive of a verruca vulgaris or pseudoepitheliomatous hyperplasia than of squamous cell carcinoma to those unfamiliar with the diagnosis. Alternatively, when it extends into underlying tissues, it may be mistaken histologically for a benign adnexal tumor or even an epidermoid cyst. Therapy may also be challenging because recurrences are common and concerns about potential anaplastic transformation after radiotherapy are often expressed.

Buschke-Loewenstein tumor: verrucous carcinoma of the penis

The Buschke-Loewenstein tumor is an anogenital tumor of characteristic clinical and histologic pattern best considered as a low-grade, well-differentiated squamous cell carcinoma. This remarkable neoplasm and its features are reviewed in detail, stressing salient advances in our understanding of it.