The authors declare that they have no competing interests.
US-P fully participated in the clinical treatment and follow-up of the patient, conceived of the study and participated in its design and coordination and helped to draft the manuscript, read and approved the final manuscript. TK fully participated in the surgical treatment and follow up of the patient, conceived of the study, participated in its design and coordination and helped to draft the manuscript, read and approved the final manuscript. Both authors read and approved the final manuscript.
Giant condyloma acuminatum or Buschke - Loewenstein tumor is a very rare disease usually located in the genital, anorectal, and perianal regions. It is locally invasive but in mostly cases displays a benign cytology on preoperative tissue sampling. Because of its low incidence little is known about treatment outcomes. Complete surgical excision is the treatment of choice. Different surgical methods have been applied to reach curability. To our knowledge such an advanced sized tumors in this localization has only been reported few times before with different surgical techniques being applied.
We describe a case of 56 years old female with 20 years persisting condyloma acuminatum progressing to a very huge dimensions perianal Buschke-Lowenstein tumor with one of the widest excision in the literature without the need for diverting stoma. The tumor size and its location determined the choice of treatment option and suspected prognosis for the patient outcome. Treatment was impeded by patient’s malnutrition. The giant Buschke - Loewenstein tumor was resected from the anus, perineum and gluteal areas. The large tissue losses were simultaneously covered with rotational skin and fatty subcutaneous tissue flaps, mobilized from neighboring gluteal and femoral areas. The circumferential part of the anal canal was covered with skin grafted from the mentioned flaps and it was attached to the anal mucosa. No protective stoma was formed. Despite temporary problems with healing of the covering skin flaps, full permanent coverage of the resection site has been achieved. Anal canal function has also improved within the time.
The patient with BLT must be very carefully clinical and imagistic investigated in order to detect the tumor visceral invasion and to establish the extension of the surgical procedure. There exists an extensive and time-consuming surgical procedure which allows to remove the giant anorectal Buschke - Loewenstein tumors with good function of the anorectum and without the necessity of diverting stoma creation.
Tas S, Arik MK, Ozkul F, Cikman O, Akgun Y. Perianal giant condyloma acuminatum-buschke-löwenstein tumor: a case report. Case Rep Surg . 2012. http://dx.doi.org/10.1155/2012/507374.
Papiu HS, Dumnici A, Olariu T, Onita M, Hornung E, Goldis D, et al. Perianal giant condyloma acuminatum (Buschke-Löwenstein tumor). Case report and review of the literature. Chirurgia (Bucur). 2011;106(4):535–9.
Wester NE, Hutten EM, Krikke C, Pol RA. Intra-abdominal localisation of a buschke-lowenstein tumour: case presentation and review of the literature. Case Rep Transplant. 2013. http://dx.doi.org/10.1155/2013/187682.
Haque W, Kelly E, Dhingra S, Carpenter LS. Successful treatment of recurrent buschke-Lowenstein tumor by radiation therapy and chemotherapy. Int J Colorec Dis. 2010;25(4):539–40. CrossRef
Spinu D, Rǎdulescu A, Bratu O, Checheritǎ IA, Ranetti AE, Mischianu D. Giant condyloma acuminatum – Buschke-Lowenstein disease – a literature review. Chirurgia (Bucur). 2014;109(4):445–50.
Uth Ovesen A. Perianal Buschke-Löwenstein tumour. Ugeskr Laeger. 2012;174(23):1616–7. PubMed
- Buschke - Loewenstein tumor resection with simultaneous reconstruction of extensive tissue losses: case report
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II