Giant condyloma of Buschke-Loewenstein in association with erythroderma

Abstract

The Buschke-Loewenstein tumour is regarded as a type of verrucous carcinoma occurring on anogenital mucosal surfaces. The tumour is locally invasive but displays a benign cytology and rarely metastasizes. It is associated with human papillomavirus types 6 and 11. We describe a case of Buschke-Loewenstein tumour occurring in a 61-year-old man which behaved in a locally aggressive manner and was associated with human papillomavirus type 16 and erythroderma which proved resistant to treatment. The patient refused surgery and therapy with interferon alpha was ineffective. Chemotherapy with systemic cisplatin and 5-fluorouracil produced a partial response before the patient succumbed from gram-negative septicaemia.

Operative Therapy of a Monstrous Buschke-Löwenstein Tumor

“…The papillomatous aspects and an infiltrating destructive growth are typical. HPV type 33, as in our case, as well as HPV types 16 and 18 are regarded as high-risk types and seem to contribute to the development of the lesion [4,5] . Also the increased expression of pRb, p53 and Ki-67 is discussed to be associated with cell-proliferative activity or tumor progression [6] and could explain the extended clinical picture in our case (Ki-67 positive).…”

Should the Surgical Management of Buschke-Lowenstein Tumors Be Aggressive? About 10 Cases

“…The perianal location ( fig. 1 ) of these lesions has been previously reported by several authors [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . This tumor is mostly developed and diagnosed in male patients.…”

“…The Buschke-Lowenstein tumor (BLT) or giant condyloma acuminata was described in 1925 on penile lesions [1][2][3] . The perianal location ( fig.…”

“…Histological examination of BLT shows a benign appearance as it is a pseudo-epitheliomatous proliferation characterized by exo-and endophytic hyperpapillomatosis with epithelial hyperplasia, hyperacanthosis and koilocytosis; transition toward squamous epithelial cancer does not appear with distinctive pathological characteristics [1,3,4,7,9,12,15] . Moreover, those tumors behave malignantly by destroying adjacent tissues.…”

“…Environmental risk factors are essentially linked to HPV contamination risk factors: young age, high number of sexual partners, unpro-tected intercourse and anal intercourse [7-10, 12, 15, 16] . Its evolution toward squamous cell carcinoma (SCC) has been previously described, the diagnosis of which is made on deep biopsies or surgical specimens [1,7,8] . Usually, these lesions are not associated with metastasis [1, 7-9, 12, 13, 16] .…”