Wide local excision for Buschke-Löwenstein tumor or circumferential carcinoma in situ

Abbas, Maher A.

doi:10.1007/s10151-011-0715-3

Cited by 14 publications

(6 citation statements)

References 32 publications

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“…Partial or complete dehiscence is not uncommon as in our experience but with a good follow up anal stenosis is rare. 6,7 …”

Section: Discussionsupporting

confidence: 84%

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Reconstructive surgery in anal giant condyloma: Report of two cases

Mingolla¹,

Poti²,

Carbotta³

et al. 2013

International Journal of Surgery Case Reports

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INTRODUCTIONGiant anal condyloma also called Buschke–Löwenstein tumor is a rare sexually transmitted disease involving anogenital region with potential malignant degeneration into invasive squamous carcinoma. Complete surgical excision is the treatment of choice and often wide wounds are necessary to reach clear margins and prevent recurrence.PRESENTATION OF CASEThe authors present two cases treated with an S-plasty rotating and a bilateral house advancement flap respectively with good functional result.DISCUSSIONGiant anal condyloma also called Buschke–Löwenstein tumor is a large exophytic, cauliflower-like mass that is characterized by local aggressive behavior. Immunosuppression favors rapid growth of the condylomas and increases the risk of their malignant transformation. In limited lesions primary excision can be safely performed leaving wounds open to granulate while in more extensive lesions flap or skin graft coverage is preferable to decrease the length of recovery and minimize risk of severe anal stricture. Abdominoperineal resection should be performed for more extensive lesions with deep invasion, malignant transformation or tumor recurrence.CONCLUSIONGiant anal condyloma also called Buschke–Löwenstein is a rare pathology with mainly sporadic single center experience reported in literature. Surgical complete excision remains the best treatment although elevate should be eventual recurrence. No sufficient data are available to recommend any medical treatment such as interferon, radiotherapy or chemotherapy.

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“…Partial or complete dehiscence is not uncommon as in our experience but with a good follow up anal stenosis is rare. 6,7 …”

Section: Discussionsupporting

confidence: 84%

“…A combination of bowel cleansing, low fiber diet and loperamide can be administered to reduce early contamination with feces of the wound. 7–9 …”

Section: Discussionmentioning

confidence: 99%

Reconstructive surgery in anal giant condyloma: Report of two cases

Mingolla¹,

Poti²,

Carbotta³

et al. 2013

International Journal of Surgery Case Reports

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“…These tumors are deep, friable masses and some could be extremely vascularized. The advantage of en bloc wide resection with a 1 cm margin is the ability to histologically examine the entire specimen to ensure clear margins and to evaluate for foci of SCC[15,16]. Surgical excision may be carried out in a single operation or as staged resection if the size of the condyloma is large (> 50% anal circumference) and if anal canal is involved for sphincter preservation.…”

Section: Discussionmentioning

confidence: 99%

Anal carcinoma in giant anal condyloma, multidisciplinary approach necessary for optimal outcome: Two case reports and review of literature

Shenoy¹,

Nittala²,

Assaf³

2019

WJGO

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BACKGROUNDAnal cancers are caused by human papilloma virus (HPV). Buschke-Lowenstein tumor also known as giant anal condyloma (GCA) is a variant of giant neglected anal tumors arising from warts caused by HPV infection. HPV are a family of double-stranded DNA viruses and primarily cause sexually transmitted disease of the genitalia and oropharyngeal mucosa. These tumors are slow growing; locally destructive large verrucous masses.CASE SUMMARYWe present a series of two cases with large anal tumors harboring invasive cancers and highlight their presentation and management. Tumors with high risk HPV subtypes (HPV 16, 18, 31, 33) may progress into invasive squamous cell carcinoma (SCC). Untreated GCA can attain enormous size and extend into the pelvic organs and bony structures. Some tumors show malignant degeneration into SCC and are often difficult to diagnose given the large size of the tumors. Complete surgical excision with negative margins is the treatment of choice and necessary to prevent recurrence. This is often not feasible and leaves large surgical wounds with tissue defects with delay in healing and increases post-operative morbidity. Pelvic reconstructive techniques including muscle flaps and grafts are often necessary to close the defects. Human immunodeficiency virus and immunocompromised patients generally do poorly with standard treatments.CONCLUSIONA multidisciplinary team of colorectal and plastic surgeons, medical and radiation oncologists along with combination treatment modalities are necessary when malignant transformation occurs in GCA, for optimal outcomes.

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“…Some authors prefers other treatment such as solution with podofilox solution [14]. Some authors do not prefer harvesting a stoma in these patients, but only prescribing low fibre diet, loperamide and bowel cleansing in post-operative period [15,16].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Giant Genital Warts

et al. 2014

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Abstract. Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the human papillomavirus, arising more frequently in the vulvar and perianal regions as large exophytic cauliflower-like mass. Estimated rate of recurrence is 60 to 66%, while malignant transformation is possible and it has been reported in 30 to 56% of cases. A 45-years-old woman was admitted to our Structure of Plastic and Reconstructive Surgery, Siena, Italy with an extensive cauliflower-like masses diffused on vulvar and perianal region. The patient was treated in general anaesthesia, with a wide en bloc excision up to free clinical edges and immediate reconstruction of the vulvar continuity. Buschke Lowenstein tumour or giant genital warts is a sporadic tumour with an elevate local recurrence rate. In some cases, surgery can be very difficult and it must be associated to other strategies. An accurate follow-up is always necessary.

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Wide local excision for Buschke-Löwenstein tumor or circumferential carcinoma in situ

Cited by 14 publications

References 32 publications

Reconstructive surgery in anal giant condyloma: Report of two cases

Reconstructive surgery in anal giant condyloma: Report of two cases

Anal carcinoma in giant anal condyloma, multidisciplinary approach necessary for optimal outcome: Two case reports and review of literature

A Case Report of Giant Genital Warts

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