Giant anogenital tumor of Buschke–Löwenstein in a patient living with human immunodeficiency virus/acquired immunodeficiency syndrome: a case report

Abstract

Background Buschke–Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke–Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients. Case presentation We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ‘’butterfly wing’’ structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm3) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke–Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection. Conclusion Buschke–Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.

Retrospective Evaluation of Clinic, Pathologic and Prognostic Characteristics of Anogenital Warts

“…22 Genital siğiller, HIV bulaşı için risk oluştururken, HIV sebepli immünsupresyon da HPV enfeksiyonunun malign dönüşüm riskinde artışa, disseminasyona ve tedaviye dirençli olmasına sebep olmaktadır. 23,24 Ayrıca, 1.209 hastanın incelendiği bir çalışmada, HIV (+) olgularda HIV (-) olgulara kıyasla gonore, trikomonas vajinalis, sifiliz ve kondiloma aküminata görülme sıklığı yüksek bulunmuştur. 25 Kaymak ve ark.nın 2004 yılında yayımlanan çalışmalarındaki 50 hastanın 13'ünde, ikinci bir CYBH bulunduğu, AGV'ye tinea inguinalis, trikomonas vajinalis, nongonokoksik üretrit, sifiliz, gonore, skabiyes, genital herpes ve vajinal kandidiyazisin eşlik ettiği bildirilmiştir.…”

“…Tedavi yöntemleri içerisinde en yüksek klirens oranına sahip cerrahi eksizyonda bile %20-30 nüks oranları bildirilmiştir. [24][25][26][27][28] Klirens oranlarını artırmak ve rekürrensleri önleyebilmek için destrüktif, immünomodülatör ve cerrahi tedavilerin kişiselleştirilmiş kombinasyon şemaları şeklinde planlanması ve aşılanma oranlarının artırılması tüm kılavuzların ortak önerisidir. 28,29 Çalışmamızda, hastaların yaklaşık %30'luk bir kısmı polikliniğimize jinekoloji, üroloji ve genel cerrahi gibi diğer bölümlerden yönlendirilmiştir.…”

Vulvar condyloma of Buschke and Löwenstein: an unusual tumour in developed countries

“…The recurrence rate is high (60%–70%) and malignant transformation may occur in about 30% to 56% of patients 6 8 9. HIV-positive patients present higher susceptibility to rapid progression, recurrence and malignant transformation and may present a clinical challenge in achieving optimal therapeutic management 8 10 11. Screening for other sexually transmitted infections is essential.…”

Penile Buschke-Lowenstein tumor in HCV patient

“… 1 , 2 Patients with immunodeficiency or comorbidities are prone to developing faster progression (growth and malignancy) or a higher rate of recurrence than patients who are not immunocompromised. 1 , 2 , 3 If left untreated, BLT can spread into the pelvis, resulting in a number of bothersome symptoms and complications, such as fistula and abscess formation. 1 We present a case of an immunocompromised male patient co-infected with hepatitis C virus who was affected by penile lesions.…”