The Pathogenesis of Giant Condyloma Acuminatum (Buschke-Lowenstein Tumor): An Overview

Abstract

Giant condyloma acuminatum, also known as Buschke-Lowenstein tumor (BLT), is a rare disease of the anogenital region. BLT is considered a locally aggressive tumor of benign histological appearance, but with the potential for destructive growth and high recurrence rates. BLT development is strongly associated with infection with low-risk human papillomaviruses (HPVs), mostly HPV-6 and -11. Immunity to HPVs plays a crucial role in the natural control of various HPV-induced lesions. Large condyloma acuminata are frequently reported in patients with primary (e.g., DOCK8 or SPINK5 deficiencies) and secondary (e.g., AIDS, solid organ transplantation) immune defects. Individuals with extensive anogenital warts, including BLT in particular, should therefore be tested for inherited or acquired immunodeficiency. Research into the genetic basis of unexplained cases is warranted. An understanding of the etiology of BLT would lead to improvements in its management. This review focuses on the role of underlying HPV infections, and human genetic and immunological determinants of BLT.

Integrated analysis of long non‐coding RNAs and mRNAs associated with condyloma acuminatum

“…While the downregulated DEGs were mainly enriched in pathways, including the calcium signaling pathway, the cAMP signaling pathway, the cGMP‐PKG signaling pathway, cell adhesion molecules, the Rap1 signaling pathway, and metabolism‐related pathways. These results show that cell cycle and immune response‐related processes were involved in CA during virus infection, consistent with the characters of CA reported before, such as proliferation and differentiation of epithelial cell, immunity, and energy metabolism 41–43 …”

“…genes were mainly involved in biological process like the cell cycle and immune response, which is in agreement with previous reports, while downregulated GO terms were correlated with cell-cell adhesion, cell junction assembly, and development. Upregulated DEGs were enriched in KEGG pathways, including cytokine-cytokine receptor interaction, viral protein interaction with cytokine and cytokine receptors, cell cycle, DNA replication, IL-17 signaling pathway, human T-cell leukemia virus 1 infection, Th17 cell differentiation, P53 signaling pathway, apoptosis and et al These results are consistent with previous reports on the characters of CA, such as cell cycle38 characterized by anomalous proliferation of keratinocytes, apoptosis,39 and widespread immune response 40,41. The P53 signaling pathway was reported to contribute to regulation of the host cell cycle and apoptosis.…”

Electrosurgery on Giant Condyloma Acuminata

“…The gold standard therapy for GCA is resection of GCA tissue to a lesion-free area. There are several resection modalities for GCA, including classic surgery, laser surgery and electrosurgery (Nieves-Condoy et al, 2021;Purzycka-Bohdan et al, 2022). Electrosurgery therapy in GCA cases has the advantage of being able to remove partially or completely of the GCA lesions in one therapy, but this cannot prevent disease recurrence (Baigrie et al, 2022;Workowski & Berman, 2011).…”

Case report on verrucous vulva carcinoma in an HIV-seropositive woman

“…Verrucous vulvar cancers are a rare subtype of SCC of the vulva. Often misdiagnosed as a Buschke-Lowenstein tumour (giant condylomata acuminata), verrucous vulva carcinoma is an aggressive locally invasive malignancy typically incapable of metastasis [2] . The aetiology of vulvar cancer is linked to the human papilloma virus infection in women of reproductive age; and chronic inflammation in post-menopausal women.…”