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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hsu FC, Yu DS, Pu TW, Wu MJ, Meng E. Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report. World J Clin Cases 2023; 11:7107-7112. [PMID: 37946780 PMCID: PMC10631422 DOI: 10.12998/wjcc.v11.i29.7107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Giant condyloma acuminatum (GCA) is an uncommon condition affecting the anogenital area. CASE SUMMARY Here, we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft, pubis region, and groin as well as urine leakage along the distal penile shaft. Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base, which was initially suspected to be a urethral fistula. However, during surgery, it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening, with infection and high pressure causing subsequent skin perforation. He underwent circumcision and wide excision with electrocauterization of the warts. He was discharged after the surgery, and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil. CONCLUSION Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.
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Affiliation(s)
- Fu-Chieh Hsu
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Dah-Shyong Yu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Ta-Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Min-Jui Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - En Meng
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
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Riethmuller D, Buisson A, Thong Vanh C, Istasse F, Valmary-Degano S, Michy T, Hoffmann P. [ Giant condyloma acuminatum in pregnancy]. ACTA ACUST UNITED AC 2021; 50:201-204. [PMID: 34403829 DOI: 10.1016/j.gofs.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- D Riethmuller
- Département de GO et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France.
| | - A Buisson
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - C Thong Vanh
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - F Istasse
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - S Valmary-Degano
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - T Michy
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - P Hoffmann
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
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Chen X, Zhou Y, Tan Y, Duan G, Li Z, Zou P, Xiao R, Zhan Y. Successful management of giant condyloma acuminatum of vulva with the combination of surgery and photodynamic therapy: Report of two cases. Photodiagnosis Photodyn Ther 2020; 31:101847. [PMID: 32479901 DOI: 10.1016/j.pdpdt.2020.101847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/15/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
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.
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Affiliation(s)
- Xiufang Chen
- Department of Dermatology, Changsha Central Hospital, Changsha 410007, China
| | - Ying Zhou
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yixin Tan
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Guozhen Duan
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zhihui Li
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Puyu Zou
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Rong Xiao
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yi Zhan
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
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Elfatoiki FZ, Hali F, Baghad B, Marnissi F, Chiheb S. Giant perianal condyloma acuminatum in an infant without sexual abuse. Arch Pediatr 2019; 26:473-474. [PMID: 31607417 DOI: 10.1016/j.arcped.2019.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 03/29/2019] [Accepted: 09/20/2019] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- F Z Elfatoiki
- Department of Dermatology, Ibn Rochd UHC, 1, quartier des hopitaux, 20000, Casablanca, Morocco.
| | - F Hali
- Department of Dermatology, Ibn Rochd UHC, 1, quartier des hopitaux, 20000, Casablanca, Morocco
| | - B Baghad
- Department of Dermatology, Ibn Rochd UHC, 1, quartier des hopitaux, 20000, Casablanca, Morocco
| | - F Marnissi
- Department of Anatomo-pathology, Ibn Rochd UHC, 1, quartier des hopitaux, 20000, Casablanca, Morocco
| | - S Chiheb
- Department of Dermatology, Ibn Rochd UHC, 1, quartier des hopitaux, 20000, Casablanca, Morocco
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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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Khullar G, Narang T, De D, Nahar Saikia U, Dogra S, Handa S. Recalcitrant giant condyloma acuminatum treated successfully with a novel combination of Mycobacterium indicus pranii immunotherapy and acitretin. Int J STD AIDS 2017. [PMID: 28632472 DOI: 10.1177/0956462417694805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Giant condyloma acuminatum occurs infrequently in children and adolescents. It is a challenging condition which is difficult to treat with both surgical and medical modalities. We present a case of a 15-year-old boy with giant condyloma acuminatum of the glans penis refractory to several therapeutic modalities. The lesions were treated successfully with a novel combination of Mycobacterium indicus pranii immunotherapy and acitretin. There was no recurrence of lesions after two years of follow-up.
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Affiliation(s)
- Geeti Khullar
- 1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- 1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- 1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- 2 Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- 1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- 1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
INTRODUCTION Buschke–Löwenstein tumour, also known as Giant condyloma acuminatum, is a rare, sexually transmitted disease that affects ano-genital region. BLT is a slow growing cauliflower-like tumour, locally aggressive and destructive. Human papillomavirus has been identified as an important contributory factor in the development of tumour. PRESENTATION OF CASE A 45 year uncircumcised male presented with complaints of cauliflower like growth on glans penis. Growth started as a small papule on the corona sulcus at 12 O’clock position 6 months back. Patient developed pain and dysuria due to compression of urethral meatus. Patient has history of multiple sexual partners. DISCUSSION BLT, first described by Buschke and Lowenstein in 1925. They observed a penile lesion that clinically resembled both common condyloma acuminata and squamous cell carcinoma, but differing from both of them regarding the biological behaviour and the histopathological appearance. GCA can be differentiated from ordinary condylomas by the characteristic “pushing” rather than “infiltrating” effect that tends to compress and displace the underlying tissue. CONCLUSION We have successfully treated a penile BLT with surgical excision and no relapse up to 6 months. Surgical excision could be considered an effective therapy in the treatment.
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Affiliation(s)
- Sunil Agarwal
- NIMS Medical College, Department of General Surgery, Jaipur, Rajasthan 303121, India.
| | - Gaurav Kumar Nirwal
- NIMS Medical College, Department of General Surgery, Jaipur, Rajasthan 303121, India
| | - Harendra Singh
- NIMS Medical College, Department of General Surgery, Jaipur, Rajasthan 303121, India
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El Amrani F, Hassam B. [Buschke-Löwenstein tumor]. Pan Afr Med J 2013; 14:94. [PMID: 23717710 PMCID: PMC3664873 DOI: 10.11604/pamj.2013.14.94.2463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 02/19/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Fadwa El Amrani
- Service de Dermatologie, CHU Ibn Sina, Université Med V, Souissi, Rabat, Maroc
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Ulas M, Bostanci EB, Teke Z, Karaman K, Ercan M, Sakaogullari Z, Akoglu M. Giant anorectal condyloma acuminatum of buschke-lowenstein: successful plastic reconstruction with bilateral gluteal musculocutaneous v-y advancement flap. Indian J Surg 2012; 75:168-70. [PMID: 24426553 DOI: 10.1007/s12262-012-0579-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 10/15/2011] [Indexed: 10/28/2022] Open
Abstract
A 58-year-old male patient presented with an anorectal verrucous carcinoma, also known as Buschke-Lowenstein tumor. Clinically, the lesion of the patient best resembled giant condyloma acuminatum with a cauliflower-like appearance. The diagnosis was confirmed with biopsy and an abdominoperineal resection was performed. The perineal defect was reconstructed with bilateral gluteal musculocutaneous V-Y advancement flap. Both functional and cosmetic results 6 years after the operation were excellent. To date, no recurrence has been noted. As long as one is aware of its existence and of its characteristic appearances, the Buschke-Lowenstein tumor is fairly easily diagnosed. The treatment of choice remains surgical resection, and adequate follow-up is essential.
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Affiliation(s)
- Murat Ulas
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
| | - E Birol Bostanci
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
| | - Zafer Teke
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey ; Gerzele Mah., Yesilada Sitesi, 544 Sok., No: 3, A-Blok, Kat: 4, Daire: 9, 20055 Servergazi, Denizli Turkey
| | - Kerem Karaman
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
| | - Metin Ercan
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
| | - Zisan Sakaogullari
- Department of Pathology, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
| | - Musa Akoglu
- Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey
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