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Kordeva S, Pidakev I, Tchernev G. Fine scalpel surgery: preserving the dartos muscle in a patient with scrotal and perigenital giant Buschke-Löwenstein tumors. Wien Med Wochenschr 2024:10.1007/s10354-024-01039-7. [PMID: 38587714 DOI: 10.1007/s10354-024-01039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
Giant condyloma acuminatum (GCA), alternatively referred to as a Buschke-Löwenstein tumor (BLT), is an uncommon, benign, but locally aggressive form of verrucous carcinoma. The condition usually affects the male population under the age of 50 years; however, there have been rare reports of pediatric cases. Various risk factors such as smoking, diabetes, promiscuous behavior, poor hygiene, immunosuppression, and others are linked to the development of this condition. We present the case of a 26-year-old male patient who came to the dermatology department with primary complaints of 10-year-old verrucous tumor formations located in the perigenital and perianal areas. Serological tests for AIDS, hepatitis B, hepatitis C, Chlamydia trachomatis, and syphilis were negative. The routine blood tests were slightly abnormal. Histological verification of condylomata acuminata of Buschke-Löwenstein was made. Given the sensitive areas, surgery was advised. With several fine undermining scalpel excisions, the lesions in the scrotal and perigenital areas were removed and the dartos muscle was preserved. Electrodissection and shave curettage were not performed. The postoperative period passed without complications and no recurrences in the perigenital area were reported. We believe that our case report represents the first documented surgical approach for scrotal Buschke-Löwenstein tumor using exclusively fine undermining scalpel surgery. A brief literature review of the condition is presented, focusing on the currently available treatment options and highlighting the potential effectiveness of the surgical approach.
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Affiliation(s)
- S Kordeva
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria.
| | - I Pidakev
- Department of Common, Abdominal and Vascular Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria
| | - G Tchernev
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
- Department of Dermatology and Venereology, Medical Institute of Ministry of Interior, General Skobelev 79, 1606, Sofia, Bulgaria
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Sivapalan S, Loving BA, Ramanathan S, Schukow CP, Robertson JM. Radiation Therapy in the Management of Extensive Giant Condyloma Acuminata With Rectal Involvement: A Case Report. Cureus 2024; 16:e56882. [PMID: 38659525 PMCID: PMC11041860 DOI: 10.7759/cureus.56882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Giant condyloma acuminata (GCA) is a rare, locally aggressive manifestation of human papillomavirus (HPV) infection, typically affecting the anorectal area. Patients with GCA often have a poor prognosis due to the high risk of malignant transformation. In this case report, we present a 39-year-old man with HIV who developed progressive and refractory anorectal GCA. Despite initially non-cancerous pathology results, there were concerns regarding a malignant component to the mass. Multidisciplinary discussions led to the decision to pursue definitive radiation therapy. This case report and review of the literature highlight the role of radiation in the management of GCA and the importance of a multidisciplinary approach in the treatment of complex cases.
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Affiliation(s)
- Shaveena Sivapalan
- Radiation Oncology, Michigan State University College of Osteopathic Medicine, East Lansing, USA
| | | | - Siddharth Ramanathan
- Radiation Oncology, Oakland University William Beaumont School of Medicine, Rochester Hills, USA
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3
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Ye Q, Jia M, Deng LJ, Fang S. Cutaneous Verrucous Carcinomas: A Review. J Cutan Med Surg 2023; 27:150-156. [PMID: 36789508 DOI: 10.1177/12034754231155895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Verrucous carcinoma (VC) is a relatively rare locally aggressive, slow-growing, well-differentiated squamous cell carcinoma with minimal metastatic potential and is most frequent in the mucosa. Although rarely reported on the skin, cutaneous verrucous carcinomas (CVC) can appear anywhere, most commonly on the feet. However, clinical and pathologic diagnosis of CVC has been confusing and challenging. It can easily be mistaken for benign or more malignant conditions such as giant condyloma acuminata, keratoacanthoma, and pseudoepithelioma-like hyperplasia or squamous cell carcinoma, resulting in inappropriate management. In this review, we describe the different aspects associated with CVC, including its pathogenesis and clinicopathologic features. The available evidence for the differential diagnosis and treatment of CVC is discussed, and specific management recommendations are made. After the treatment, careful follow-up examinations of the excised area should be performed at regular intervals.
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Affiliation(s)
- Qian Ye
- 117972 Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Meng Jia
- 117972 Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li-Jia Deng
- 117972 Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Sheng Fang
- 117972 Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Cokan A, Pakiž M, Serdinšek T, Dovnik A, Kodrič T, Repše Fokter A, Kavalar R, But I. Comparison of Conservative Treatment of Cervical Intraepithelial Lesions with Imiquimod with Standard Excisional Technique Using LLETZ: A Randomized Controlled Trial. J Clin Med 2021; 10:5777. [PMID: 34945073 PMCID: PMC8706260 DOI: 10.3390/jcm10245777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/06/2021] [Indexed: 01/10/2023] Open
Abstract
(1) Background: There are limited data on the success of conservative treatment of high-grade cervical squamous intraepithelial lesions (HSIL) with imiquimod directly compared to standard of treatment with LLETZ. (2) Methods: Patients aged 18-40 with histological HSIL (with high-grade cervical intraepithelial neoplasia, CIN2p16+ and CIN3), were randomly assigned to treatment with imiquimod or LLETZ. The primary outcome was defined as the absence of HSIL after either treatment modality. The secondary outcomes were the occurrence of side effects. (3) Results: 52 patients were allocated in each group and were similar regarding baseline characteristics. In the imiquimod group, 82.7% of patients completed treatment, which was successful in 51.9%. All patients in the LLETZ group completed treatment, which was successful in 92.3% (p < 0.001). In the subgroup of CIN2p16+ patients, treatment with imiquimod was not inferior to LLETZ (73.9% vs. 84.2%, p = 0.477). During and after treatment, no cases of progression to cancer were observed. Side effects and severe side effects (local and systemic) were more prevalent in the imiquimod than in the LLETZ group (88.5% vs. 44.2% (p-value < 0.001) and 51.9% vs. 13.5% (p-value < 0.001), respectively). (4) Conclusion: Generally, in patients with HSIL, LLETZ remains the gold standard of treatment. However, in a subgroup analysis of patients with CIN2p16+, the success rate was comparable between the two treatment modalities. Due to the prevalence of side effects, the treatment compliance with imiquimod use may, however, present a clinically important issue.
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Affiliation(s)
- Andrej Cokan
- Department for Gynaecological and Breast Oncology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (M.P.); (A.D.); (T.K.)
| | - Maja Pakiž
- Department for Gynaecological and Breast Oncology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (M.P.); (A.D.); (T.K.)
| | - Tamara Serdinšek
- Department for General Gynaecology and Urogynaecology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (T.S.); (I.B.)
| | - Andraž Dovnik
- Department for Gynaecological and Breast Oncology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (M.P.); (A.D.); (T.K.)
| | - Tatjana Kodrič
- Department for Gynaecological and Breast Oncology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (M.P.); (A.D.); (T.K.)
| | - Alenka Repše Fokter
- Medical Faculty Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia;
- General Hospital Celje, Oblakova Ulica 5, 3000 Celje, Slovenia
| | - Rajko Kavalar
- Department for Pathology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia;
| | - Igor But
- Department for General Gynaecology and Urogynaecology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia; (T.S.); (I.B.)
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Abstract
Buschke-Lowenstein tumors primarily are slow-growing giant condylomata accuminata of the anogenital region. They are locally destructive with a low rate of metastasis. Sexually transmitted oncogenic human papillomavirus type 6 and 11 are the greatest risk factors for Buschke-Lowenstein tumors or verrucous carcinomas, a type of squamous cell cancer. Grossly, the tumor appears as a large fungating, erythematous, cauliflower-like mass. Radical surgical excision of the tumor is the treatment of choice and close follow-up for recurrence is essential. The use of radiation or chemotherapy as adjunct treatments is controversial. This case report describes a patient with this rare condition.
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Zhang D, Gonzalez RS, Feely M, Umrau K, Lee H, Allende DS, Karamchandani DM, Zaleski M, Lin J, Westerhoff M, Zhang X, Alpert L, Liao X, Lai J, Liu X. Clinicopathologic features of Buschke-Löwenstein tumor: a multi-institutional analysis of 38 cases. Virchows Arch 2019; 476:543-550. [PMID: 31728626 DOI: 10.1007/s00428-019-02680-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/11/2019] [Accepted: 09/25/2019] [Indexed: 02/08/2023]
Abstract
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.
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Affiliation(s)
- Dongwei Zhang
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA. .,Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Feely
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Kavita Umrau
- Department of Pathology, Albany Medical Center, Albany, NY, USA
| | - Hwajeong Lee
- Department of Pathology, Albany Medical Center, Albany, NY, USA
| | | | - Dipti M Karamchandani
- Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Michael Zaleski
- Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jingmei Lin
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maria Westerhoff
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Xuchen Zhang
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Lindsay Alpert
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Xiaoyan Liao
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Jinping Lai
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Xiuli Liu
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
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7
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Acral Verrucous Carcinoma. CURRENT HEALTH SCIENCES JOURNAL 2019; 45:235-240. [PMID: 31624653 PMCID: PMC6778290 DOI: 10.12865/chsj.45.02.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/19/2019] [Indexed: 11/29/2022]
Abstract
Introduction. The verrucous carcinoma is a type of squamous carcinoma that is highly differentiated, relatively uncommon, locally aggressive, with slow growth and minimal metastatic potential. Clinical case. A 48-year old man was admitted to the Dermatology department of the Craiova Hospital for a round-oval tumoral mass that was hyperkeratotic, with central ulceration, covered by a hematic crust, approximately 1.5cm in size, localized at the distal phalanx of the third finger left hand, with perilesional edema and erythema. The wart-like lesion appeared 8 months beforehand, which the patient has traumatized repeatedly in the last 2 months. The histopathological examination confirmed the diagnosis of verrucous carcinoma. The X-ray examination revealed external margin osteolysis of the distal epiphysis in the third finger, left hand. The patient was transfered to the Plastic surgery department where the distal phalanx of the third finger, left hand was amputated. Discussions. Risk factors for the development of verrucous carcinoma are HPV infection, carcinogenic chemicals, smoking, chronic inflammation, repeated trauma, etc. Diagnosis is suspected by clinical appearance and confirmed histopathologically. The treatment of choice is surgical excision due to the high risk of recurrence and local invasiveness, and in the case of an advanced tumor with acral localization, amputation is preferred, as is our case. Conclusions. Verrucous carcinoma is a type of squamous carcinoma that is highly differentiated, with slow and continuous invasion of the underlying tissues. In order to establish the diagnosis of verrucous carcinoma, it is necessary to corroborate the clinical examination with histopathological and evolutionary examinations. The treatment of choice is surgical excision, but given the increased risk of recurrence, the patient should be evaluated periodically until complete healing. Our case is interesting by localization and rapid evolution with the invasion of the underlying tissues.
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8
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He X, Zhang J, Tan L, Wang W, Song Y, Wang H, Zhang X, Kou H, Lu Y. Treatment of verrucous carcinoma in penis with topical aminolevulinic acid photodynamic therapy: An effective and safe treatment method. Photodiagnosis Photodyn Ther 2018; 24:232-236. [DOI: 10.1016/j.pdpdt.2018.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 11/28/2022]
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9
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Combaud V, Verhaeghe C, El Hachem H, Legendre G, Descamps P, Martin L, Bouet PE. Giant condyloma acuminatum of the vulva: Successful management with imiquimod. JAAD Case Rep 2018; 4:692-694. [PMID: 30128340 PMCID: PMC6098202 DOI: 10.1016/j.jdcr.2018.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Vanessa Combaud
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Caroline Verhaeghe
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Hady El Hachem
- Department of Obstetrics and Gynecology, Clemenceau Medical Center, Beirut, Lebanon
| | - Guillaume Legendre
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Philippe Descamps
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Ludovic Martin
- Department of Dermatology, Angers University Hospital, Angers, France
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10
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Abstract
BACKGROUND A giant condyloma acuminatum which shows destructive growth but lacking invasion is designated as a Buschke-Lowenstein tumor (BLT). OBJECTIVES Classification of the BLT and therapeutic guidelines are provided. MATERIALS AND METHODS A MEDLINE literature search from 2006-2016 was performed. RESULTS Induction through low-risk mucosotropic human papillomavirus (HPV) infection separates BLT from verrucous carcinoma. In the last 10 years, slightly more than 100 new cases have been described. Invasion as a true sign of malignancy was described in 12% of cases. HIV infection was observed in 14%. As invasion often occurs only focally and may only be detected after complete resection, BLT must be treated and considered as a low grade in situ epithelial cancer that evolves from condylomata acuminata. Diagnosis is confirmed by HPV detection and typical histology. CT scans are recommended to rule out deeper invasion. Organ preservation surgery remains the recommended therapy. CONCLUSIONS Buschke-Lowenstein tumors represent low grade epithelial in situ carcinomas which evolved from condylomata acuminata. Focal invasion is frequent but metastases occur only rarely. Organ preservation surgery is recommended.
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Affiliation(s)
- M Sporkert
- Anästhesiologie und operative Intensivmedizin, Luisenhospital Aachen, Boxgraben 99, 52064, Aachen, Deutschland
| | - A Rübben
- Hautklinik, Universitätsklinikum der RWTH-Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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11
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Gaur MK, Goel A, Gupta S. Perianal cauliflower. ANZ J Surg 2017; 87:850. [PMID: 28975738 DOI: 10.1111/ans.14152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Manish K Gaur
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Aakanksha Goel
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Sanjay Gupta
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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12
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Pătrașcu V, Enache O, Ciurea R. Verrucous Carcinoma - Observations on 4 Cases. CURRENT HEALTH SCIENCES JOURNAL 2016; 42:102-110. [PMID: 30568820 PMCID: PMC6256150 DOI: 10.12865/chsj.42.01.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/19/2016] [Indexed: 11/18/2022]
Abstract
Verrucous carcinoma (VC) is a rare well-differentiated squamous cell carcinoma with the clinical forms: oral florid papillomatosis, epithelioma cuniculatum, papilomatosis cutis and Buschke-Löwenstein tumor. We present four patients and the four clinical forms of CV. The diagnosis we held after clinical examination and histopathological examination of the balance sheet expansion. First described by Ackermanin the oral mucosal, today it has a reported incidence of 1-3 cases per million inhabitants. CV can involve both skin and mucous membranes. Etiopathogenesis is uncertain, but participation HPV is widely accepted. WHO recognizes the CV as a rare form of well-differentiated squamous cell carcinoma with slow and continues evolution, with the invasion of underlying tissues, frequent relapses and very low risk of metastasis. The elective therapy is surgical excision with safety oncological margins. Diagnosis involves corroboration of clinical data with histopathological appearance and evolutive behavior of the tumor. Given the increased risk for recurrence, the patient should be reviewed quarterly to finding healing.
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Affiliation(s)
- V Pătrașcu
- Dermato-venerology Department, University of Medicine and Pharmacy of Craiova
| | - O Enache
- Dermato-venerology Department, University of Medicine and Pharmacy of Craiova
| | - R Ciurea
- Pathology Department, University of Medicine and Pharmacy of Craiova
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13
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Nordsiek M, Ross C, Metro M. Successful Surgical Management of Giant Condyloma Acuminatum (Buschke Lowenstein Tumor) in the Urethra of a Female Patient: A Case Report. Curr Urol 2015. [PMID: 26195964 DOI: 10.1159/000365689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Buschke-Lowenstein tumor (BLT) is a slow-growing, locally destructive verrucous plaque that typically appears on the penis but may occur elsewhere in the anogenital region. It most commonly is considered to be a regional variant of verrucous carcinoma. It is rare but accounts for 5-24% of all penile cancers. It can also affect the perineum and other portions of the genitalia. It was first described by Buschke and Löwenstein in 1925, and is also known as giant condyloma acuminatum (GCA). Regardless of the treatment modality, careful follow-up is recommended because of the high risk of recurrence and the possibility for malignant transformation in 30-56% of patients. We present a case of a 47-year-old Hispanic female that presented to the urology clinic for dysuria and upon work-up was found to have a GCA. GCA typically affects the penis, although the perianal region, vulva, vagina, rectum, scrotum, perineum and bladder may be involved. To date, we believe this is the only reported case of GCA in the urethra of a female patient with sparing of the bladder. This lesion was successfully removed with wide local excision. We believe that further studies are needed to define this disease, identify its pathogenesis, and the most successful treatment protocol.
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Affiliation(s)
- Michael Nordsiek
- Department of Urology, Albert Einstein Medical Center, Philadelphia, Pa., USA
| | - Curtis Ross
- Department of Urology, Albert Einstein Medical Center, Philadelphia, Pa., USA
| | - Michael Metro
- Department of Urology, Albert Einstein Medical Center, Philadelphia, Pa., USA
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14
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Yiu ZZN, Ali FR, Wilson MS, Mowatt D, Lyon CC. Giant condylomata acuminata of Buschke and Lowenstein: A peristomal variant. Int J Surg Case Rep 2014; 5:1014-7. [PMID: 25460461 PMCID: PMC4275778 DOI: 10.1016/j.ijscr.2014.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Giant condylomata acuminata (GCA) is a rare, locally invasive tumour that may undergo malignant transformation. It was first described a HPV-induced penile tumour which clinically resembled both a squamous cell carcinoma and condyloma acuminatum, often arising from a pre-existing warty lesion. We describe a case of peri-stomal GCA transformation into invasive squamous cell carcinoma (SCC), which is, to our knowledge, the first report of this in the literature. PRESENTATION OF CASE A 74 year old gentleman developed an acuminate, papillomatous peristomal eruption around a fifty year old ileostomy, with biopsies of the eruption showing reactive changes. Two years later, he developed ulcerating plaques affecting the previously papillomatous areas and an erythematous nodular lesion involving the superior part of the ileostomy and adjacent skin. Histological examination of the ileostomy lesion showed focal small islands of atypical squamous epithelium, and moderately differentiated invasive squamous cell carcinoma was shown in the excised tissue subsequently. Human papillomavirus (HPV type 16), p16 and p53 tumour suppressors were positive in the peri-stomal skin sample. DISCUSSION AND CONCLUSIONS Recurring, changing papillomatous lesions in the peristomal area should be reviewed with a high index of suspicion in relation to GCA tumours as they can progress to invasive squamous cell carcinomas.
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Affiliation(s)
- Z Z N Yiu
- The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | - F R Ali
- The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | | | - D Mowatt
- Christie Hospital, Manchester, UK.
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15
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Imko-Walczuk B, Cegielska A, Placek W, Kaszewski S, Fiedor P. Human papillomavirus-related verrucous carcinoma in a renal transplant patient after long-term immunosuppression: a case report. Transplant Proc 2014; 46:2916-9. [PMID: 25380950 DOI: 10.1016/j.transproceed.2014.09.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Verrucous carcinoma is a slow-growing tumor with 3 main localizations: Oral cavity, ano-urogenital region, and plantar surface of the foot. On the sole it may rise adjacent to viral warts and very often is mistaken for the common verruca plantaris. Although both conditions-viral warts and cutaneous squamous cell carcinoma-are often diagnosed in immunosuppressed patients, in literature we have found only 3 case reports of verrucous carcinoma in organ transplant recipients. CASE REPORT We present a case of 26-year-old man after deceased donor renal transplantation with plantar verrucous carcinoma successfully treated with excision and 5% imiquimod.
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Affiliation(s)
- B Imko-Walczuk
- Department of Dermatology, Copernicus Podmiot Leczniczy sp z oo, Gdańsk; Polish College of Health, Beauty Care and Education in Poznań, Gdynia.
| | - A Cegielska
- Department of Nephrology, Transplantology and Internal Diseases, Medical University, Gdańsk
| | - W Placek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Varmia and Masuria, Olsztyn
| | - Sebastian Kaszewski
- Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Collegium Medicum UMK, Bydgoszcz
| | - P Fiedor
- Department of General and Transplantation Surgery, Transplantation Institute, Warsaw, Poland
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Safi F, Bekdache O, Al-Salam S, Alashari M, Mazen T. Giant condyloma acuminatum of Buschke-Lowenstein tumour: Disease development between 2000 and 2010. SURGICAL PRACTICE 2014. [DOI: 10.1111/1744-1633.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Farouk Safi
- Department of Surgery; United Arab Emirates University; Al Ain United Arab Emirates
| | - Omar Bekdache
- Department of Surgery; Tawam Hospital; Al Ain United Arab Emirates
| | - Suhail Al-Salam
- Department of Pathology; United Arab Emirates University; Al Ain United Arab Emirates
| | - Mouied Alashari
- Department of Pathology; Tawam Hospital; Al Ain United Arab Emirates
| | - Taha Mazen
- Department of Internal Medicine; Tawam Hospital; Al Ain United Arab Emirates
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17
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Management of peri-anal giant condyloma acuminatum--a case report and literature review. Asian J Surg 2012; 36:43-52. [PMID: 23270825 DOI: 10.1016/j.asjsur.2012.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 05/22/2012] [Accepted: 06/01/2012] [Indexed: 11/22/2022] Open
Abstract
Giant condyloma acuminatum (GCA), originally described by Buschke and Loewenstein in 1925 as a lesion of the penis, is more rarely seen in the anorectum and is characterized by clinical malignancy in the face of histologic benignity; however, malignant transformation to frankly invasive squamous-cell carcinoma has been described in about one-third of patients. In addition, malignant transformation has been reported in patients with "ordinary" condylomata acuminata. Human papillomavirus, known to cause condylomata acuminata, is also known to induce these tumors and was found in 96% of 63 cases reviewed in the last 10 years. These lesions have a propensity for recurrence and a likelihood of malignant transformation, and lead to significant mortality. Therefore, early and radical R0 excision, along with vigilant follow-up, provides the hope for cure. Conservative and/or multimodal therapy has been reported in a few cases, but its effect is not yet proved. The authors report one case of GCA; in addition, they reviewed the literature over the last 10 years and compared with previous reviews.
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18
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Campolmi P, Bonan P, Cannarozzo G, Bassi A, Bruscino N, Arunachalam M, Troiano M, Lotti T, Moretti S. Highlights of thirty-year experience of CO2 laser use at the Florence (Italy) department of dermatology. ScientificWorldJournal 2012; 2012:546528. [PMID: 22593693 PMCID: PMC3347966 DOI: 10.1100/2012/546528] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 01/04/2012] [Indexed: 12/01/2022] Open
Abstract
The CO2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave CO2 laser delivery system and the newer “superpulsed” and scanned CO2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital.
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Affiliation(s)
- Piero Campolmi
- Section of Clinical, Preventive and Oncologic Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Villa S.Chiara, Piazza Indipendenza 11, 50129 Florence, Italy
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19
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Martin JM, Molina I, Monteagudo C, Marti N, Lopez V, Jorda E. Buschke-Lowenstein tumor. J Dermatol Case Rep 2011; 2:60-2. [PMID: 21886716 DOI: 10.3315/jdcr.2008.1019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Accepted: 11/12/2008] [Indexed: 11/11/2022]
Abstract
BACKGROUND Verrucous carcinoma of the skin and mucosa is an uncommon type of well-differentiated squamous cell carcinoma. When it is present in the genitoanal region the term used is Buschke-Lowenstein tumor. The human papillomavirus seems to be implicated in its aetiology. Treatment is controversial. Topical chemotherapy, radiotherapy, immunotherapy and radical surgery have been employed. MAIN OBSERVATIONS We report a rapidly progressing penile verrucous carcinoma which was treated sucessfuly with conservative surgery and CO2 laser. CONCLUSION Treatment with CO2 laser in combination with conservative surgery may be a therapeutic option in Buschke-Lowenstein tumor.
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Affiliation(s)
- Jose M Martin
- Department of Dermatology, Hospital Clinico Universitario Valencia, Spain
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20
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Kwon HB, Choi YS, Lee JH, Jin SY, Kim BJ, Lee SH, Lee AY. Treatment of verrucous carcinoma of the lower lip with topical imiquimod (aldara®) and debulking therapy. Ann Dermatol 2011; 23 Suppl 1:S68-71. [PMID: 22028577 PMCID: PMC3199427 DOI: 10.5021/ad.2011.23.s1.s68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 08/27/2010] [Accepted: 09/18/2010] [Indexed: 11/08/2022] Open
Abstract
Verrucous carcinoma is an unusual, non-metastasizing, distinct variant of squamous cell carcinoma composed of four subtypes according to the site of occurrence: oral type, anogenital type, plantar type, and other cutaneous sites. Oral type verrucous carcinoma usually shows slow progression with a low incidence of metastases. Treatment of verrcous carcinoma is challenging; multiple medical and surgical therapies are often attempted, with limited success. We reported on 2 cases of verrucous carcinoma of the lip treated with topical imiquimod and debulking therapy.
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Affiliation(s)
- Hyok Bu Kwon
- Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea
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21
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Talwar A, Puri N, Singh M. Giant condyloma acuminatum of Buschke and Lowenstein: successful surgical treatment. Int J STD AIDS 2010; 21:446-8. [PMID: 20606229 DOI: 10.1258/ijsa.2009.009159] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Buschke-Löwenstein tumour is an extremely rare, slow-growing, locally destructive, cauliflower-like mass, also known as giant condyloma acuminatum. We report a case of a 42-year-old man who presented to the department of surgery with a two-year history of a perineal tumour. The mass was painless initially but had become painful more recently. After histopathological confirmation, the tumour was removed surgically, as it was resistant to medical treatment. There has been considerable debate regarding the exact nature, aetiology and treatment of these lesions.
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Affiliation(s)
- A Talwar
- Department of Surgery and Dermatology, G.G.S. Medical College & Hospital, Punjab, India
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22
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Armstrong N, Foley G, Wilson J, Finan P, Sebag-Montefiore D. Successful treatment of a large Buschke–Lowenstein tumour with chemo-radiotherapy. Int J STD AIDS 2009; 20:732-4. [DOI: 10.1258/ijsa.2009.009012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report the case of a patient with a large Buschke–Lowenstein tumour which had previously recurred following local excision. A preferred treatment modality for this rare variant of human papillomavirus has not been clearly defined. Treatment with chemo-radiotherapy in this case resulted in complete resolution of the disease without the need for further surgical intervention.
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Affiliation(s)
- N Armstrong
- Department of Infectious Diseases and Sexual Health, Trinity Centre, Trinity Road, Bradford BD5 0JD
| | - G Foley
- The John Goligher Department of Colorectal Surgery
| | - J Wilson
- Department of Genitourinary Medicine, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX
| | - P Finan
- The John Goligher Department of Colorectal Surgery
| | - D Sebag-Montefiore
- St James Institute of Oncology, St James University Hospital, Beckett Street, Leeds LS9 7TF, UK
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23
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Azevedo LH, Galletta VC, de Paula Eduardo C, de Sousa SO, Migliari DA. Treatment of Oral Verrucous Carcinoma With Carbon Dioxide Laser. J Oral Maxillofac Surg 2007; 65:2361-6. [DOI: 10.1016/j.joms.2006.10.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 06/14/2006] [Accepted: 10/16/2006] [Indexed: 11/17/2022]
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24
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Nikkels AF, Thirion L, Quatresooz P, Piérard GE. Photodynamic therapy for cutaneous verrucous carcinoma. J Am Acad Dermatol 2007; 57:516-9. [PMID: 17434646 DOI: 10.1016/j.jaad.2007.02.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 02/05/2007] [Accepted: 02/26/2007] [Indexed: 11/20/2022]
Abstract
Cutaneous verrucous carcinoma is a low-grade and well-differentiated variant of squamous cell carcinoma. This rare neoplasm follows a seemingly indolent progression and exhibits a low metastatic potential. Photodynamic therapy relies on the selective intratumoral cell accumulation and photoactivation of a photosensitizer, leading to the generation of phototoxic compounds responsible for necrosis and apoptosis of the target cells. An 82-year-old man presenting with a large long-standing verrucous carcinoma on the leg was treated successfully by 6 photodynamic therapy sessions administered at weekly intervals using methyl-aminolevulinate and 57-J/cm(2) irradiations at 634-nm wavelength. The use of methyl-aminolevulinate-photodynamic therapy for treating cutaneous verrucous carcinoma had not been reported so far. It may represent a convenient therapeutic alternative in this setting.
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Affiliation(s)
- Arjen F Nikkels
- Department of Dermatopathology, University Hospital of Liège, Belgium.
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25
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Paraskevas KI, Kyriakos E, Poulios EE, Stathopoulos V, Tzovaras AA, Briana DD. Surgical management of giant condyloma acuminatum (Buschke-Loewenstein tumor) of the perianal region. Dermatol Surg 2007; 33:638-44. [PMID: 17451592 DOI: 10.1111/j.1524-4725.2007.33125.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kosmas I Paraskevas
- Second Department of Surgery, Konstantopoulio-Agia Olga General Hospital, Athens, Greece
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26
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Surgical Management of Giant Condyloma Acuminatum (Buschke-Loewenstein Tumor) of the Perianal Region. Dermatol Surg 2007. [DOI: 10.1097/00042728-200705000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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AlShahwan MA, AlGhamdi KM, AlSaif FM. Verrucous carcinoma presenting as giant plantar horns. Dermatol Surg 2007; 33:510-2. [PMID: 17430391 DOI: 10.1111/j.1524-4725.2007.33105.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohammed A AlShahwan
- Dermatology Department, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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28
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Verrucous Carcinoma Presenting as Giant Plantar Horns. Dermatol Surg 2007. [DOI: 10.1097/00042728-200704000-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Abstract
Buschke-Löwenstein tumour is classified as a verrucous carcinoma. It presents like an exophytic tumour of the genital or peri-anal area, with ulceration and sometimes fistulae and sinuses. It is preferentially seen in men and immunocompromised patients. Histological appearance is not far from condyloma acuminata, but with a tendency to compress and displace deeper tissues, without basement membrane disruption. HPV types 6 or 11 are regularly found in association with this tumour. Other STI have to be searched. Physical examination and precise imagery are useful to chose the right treatment regimen. Radical excision is recommended to avoid malignant transformation, but has to be large because of the high number of recurrences. Other treatment modalities such as chemotherapy or imiquimod could be of interest to avoid mutilating surgical interventions. A regular follow-up is necessary because of frequent recurrences and possible malignant transformation.
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Affiliation(s)
- A Lévy
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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30
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Schalock PC, Kornik RI, Baughman RD, Chapman MS. Treatment of verrucous carcinoma with topical imiquimod. J Am Acad Dermatol 2006; 54:S233-5. [PMID: 16631950 DOI: 10.1016/j.jaad.2005.10.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Revised: 09/30/2005] [Accepted: 10/18/2005] [Indexed: 11/25/2022]
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31
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Chaidemenos G, Kogia M, Souparis A, Kastoridou C, Karakatsanis G, Xenidis E, Mourellou O. Radical Excision and Mesh-Skin Grafting for Giant Anorectal Condyloma Acuminatum. Dermatol Surg 2006; 32:324-8. [PMID: 16442064 DOI: 10.1111/j.1524-4725.2006.32060.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Giant Condyloma Acuminatum (GCA) presents difficulties in therapeutic management, mainly due to local invasion and recurrences. Treatment measures vary from topical agents to aggressive methods such as surgical excision, radiation, laser surgery, chemotherapy, immunotherapy or their combination. METHOD A 48-year-old heterosexual, HIV-negative male with a 20 year-year history of GCA, following an unsuccessful surgical operation, underwent radical excision with immediate mesh-skin grafting. CONCLUSION The absence of relapse and the excellent cosmetic results obtained one and a half years post-operative may put this treatment option in the first line of treatment choices for GCA
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Affiliation(s)
- G Chaidemenos
- Department of Dermatology, State Hospital of Dermatology and Venereal Diseases, Thessaloniki, Greece
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32
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Radical Excision and Mesh-Skin Grafting for Giant Anorectal Condyloma Acuminatum. Dermatol Surg 2006. [DOI: 10.1097/00042728-200602000-00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- J-M Bonnetblanc
- Service de Dermatologie, CHRU Dupuytren, 2, avenue Martin Luther King, 87032 Limoges Cedex
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Abstract
Further understanding of the pathogenesis of dermatologic conditions at a molecular level has led to targeted therapies. The topical immune response modifiers have contributed significantly to the treatment of cutaneous diseases. New topical remedies, particularly the Toll-like receptor agonists and calcineurin inhibitors, have added to the clinical armamentarium and have further advanced clinicians' ability to treat a wide variety of benign, premalignant, and malignant conditions. Furthermore, these agents have contributed to the understanding of the disease process. The next decade will witness even greater advances in targeted immunotherapies for dermatologic disease.
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Affiliation(s)
- Daniel N Sauder
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205-0900, USA.
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35
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Qarro A, Ait Ali A, Choho A, Alkandry S, Borki K. Tumeur de Buschke- Lowenstein à localisation anorectale. ACTA ACUST UNITED AC 2005; 130:96-100. [PMID: 15737321 DOI: 10.1016/j.anchir.2004.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Accepted: 06/16/2004] [Indexed: 11/24/2022]
Abstract
Buschke-Lowenstein tumor or giant condyloma acuminata is characterized by a proliferation locally aggressive with extensive tissue destruction. We report three cases of Buschke-Lowenstein tumor with anorectal localization. The histology is characterized by papillomatosis and endo or exophytic acanthosis secondary to papillomavirus. The variety of treatment regimens applied do not allow formulation of definitive therapeutic guidelines.
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Affiliation(s)
- A Qarro
- Service de chirurgie viscérale-II, hôpital militaire d'instruction Med V Rabat, Maroc.
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36
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Hara H, Honda A, Suzuki H, Sata T, Matsukura T. Detection of Human Papillomavirus Type 58 in Polydactylous Bowen’s Disease on the Fingers and Toes of a Woman – Concurrent Occurrence of Invasive Vulval and Cervical Carcinomas. Dermatology 2004; 209:218-22. [PMID: 15459536 DOI: 10.1159/000079893] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2003] [Accepted: 03/27/2004] [Indexed: 11/19/2022] Open
Abstract
The group related to human papillomavirus (HPV) type 16 (HPV-16, -31, -33, -35, -52, -58 and -67) is dominantly identified in cervical intraepithelial neoplasia and cervical carcinomas. HPV-16 has also been frequently detected in Bowen's disease on the hands and feet. We describe herein a case of polydactylous Bowen's disease on the fingers and toes of a woman who had had radical vulvectomy and hysterectomy for concomitant invasive vulval and cervical carcinomas. All the lesions, except for the lesions on the periungual side of her left index, middle and ring fingers, harbored HPV-58 DNA with more than 100 entire viral genome copies per cell detected by Southern blot hybridization. The histological localization of the viral DNA was confirmed in all the lesions by in situ hybridization. We could also retrospectively demonstrate HPV-58 DNA in her invasive vulval and cervical carcinoma tissues.
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Affiliation(s)
- Hiroyuki Hara
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan.
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38
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Koch H, Kowatsch E, Hödl S, Smola MG, Radl R, Hofmann T, Scharnagl E. Verrucous carcinoma of the skin: long-term follow-up results following surgical therapy. Dermatol Surg 2004; 30:1124-30. [PMID: 15274703 DOI: 10.1111/j.1524-4725.2004.30338.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Owing to the benign appearance and slow growth of verrucous carcinoma of the skin, its diagnosis and therapeutic management still pose problems. OBJECTIVE This study was undertaken to point out clinical and histopathologic features of verrucous carcinoma of the skin and to provide diagnostic and therapeutic guidelines on the basis of the long-term results from 20 patients. METHODS A retrospective study of the long-term results of 20 patients treated surgically for verrucous carcinoma of the skin is presented. In 16 cases, a wide resection with histopathologic examination of the margins was possible. Two tumors were shaved; 1 case required below-knee amputation and 1 patient refused primary amputation. In April 1999, 9 of the 10 surviving patients underwent physical examination, ultrasonography of the regional lymph nodes and the abdomen, and chest X-ray. The protocols of autopsies or postmortem examinations of the deceased patients were consulted. RESULTS The deceased patients achieved an average tumor-free survival period of 86.1 months; eight of the surviving patients had an average tumor-free follow-up of 127.4 months. Two patients suffered recurrences. CONCLUSION Curative treatment can be achieved by timely and complete resection of verrucous carcinoma of the skin, even in advanced cases.
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MESH Headings
- Aged
- Aged, 80 and over
- Austria/epidemiology
- Carcinoma, Verrucous/epidemiology
- Carcinoma, Verrucous/etiology
- Carcinoma, Verrucous/mortality
- Carcinoma, Verrucous/pathology
- Carcinoma, Verrucous/surgery
- Decision Trees
- Disease-Free Survival
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/etiology
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Retrospective Studies
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Survival Analysis
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Affiliation(s)
- Horst Koch
- Division of Plastic Surgery, Department of Surgery, University Hospital, Graz, Austria.
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