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Chromy D, Silling S, Wieland U, Kreuter A. [Anogenital warts-An update]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:30-39. [PMID: 38108864 DOI: 10.1007/s00105-023-05282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
With a prevalence of around 1% in the sexually active population anogenital warts are the most frequent human papillomavirus (HPV)-related disease. In the vast majority of cases the underlying cause of the infection is due to HPV types 6 and 11. The diagnosis can usually be clinically established but in certain cases a histopathological work-up can be useful. Buschke-Lowenstein tumors represent such a scenario. The current therapeutic armamentarium for anogenital warts ranges from surgical ablative procedures up to local immunomodulatory treatment. All procedures have different advantages and disadvantages and are relatively time-consuming and sometimes also unpleasant for the patient. Anogenital warts are also a possible expression of an incomplete immunological control of HPV. Therefore, it should be emphasized that for certain affected individuals, especially immunosuppressed patients, special attention should be given to ensuring that screening investigations for HPV-associated dysplasia is carried out according to the respective valid guidelines. The primary prophylaxis by vaccination of girls and boys prior to first HPV exposure represents a very effective option to drastically reduce the prevalence of anogenital warts and other HPV-related diseases.
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Affiliation(s)
- David Chromy
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich.
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
| | - Steffi Silling
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln und Universität zu Köln, Köln, Deutschland
| | - Ulrike Wieland
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln und Universität zu Köln, Köln, Deutschland
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen, Deutschland
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinik Duisburg, Duisburg, Deutschland
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Hsu FC, Yu DS, Pu TW, Wu MJ, Meng E. Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report. World J Clin Cases 2023; 11:7107-7112. [PMID: 37946780 PMCID: PMC10631422 DOI: 10.12998/wjcc.v11.i29.7107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Giant condyloma acuminatum (GCA) is an uncommon condition affecting the anogenital area. CASE SUMMARY Here, we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft, pubis region, and groin as well as urine leakage along the distal penile shaft. Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base, which was initially suspected to be a urethral fistula. However, during surgery, it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening, with infection and high pressure causing subsequent skin perforation. He underwent circumcision and wide excision with electrocauterization of the warts. He was discharged after the surgery, and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil. CONCLUSION Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.
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Affiliation(s)
- Fu-Chieh Hsu
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Dah-Shyong Yu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Ta-Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - Min-Jui Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
| | - En Meng
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
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Harris SR, Wan KM. Giant condyloma acuminatum (Buschke-Lowenstein tumour) of the vagina during pregnancy. BMJ Case Rep 2023; 16:e255996. [PMID: 37788919 PMCID: PMC10551869 DOI: 10.1136/bcr-2023-255996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
A primiparous woman in her mid-30s presented at 31 weeks of gestation with a large vaginal mass obstructing the cervix, initially concerning for malignancy. Pelvic MRI confirmed a vaginal lesion located on the lateral wall, and histopathology diagnosed a giant condyloma acuminatum. The vaginal lesion was surgically resected at 34 weeks of gestation, and the patient proceeded to have a successful vaginal birth. Our case report demonstrates an unusual presentation of a rare anogenital disease and highlights a differential diagnosis for cervical and vaginal lesions.
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Affiliation(s)
- Stella Rose Harris
- Department of Gynaecological Oncology, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - King Man Wan
- Department of Gynaecological Oncology, The Royal Hospital for Women, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Mihailov R, Tatu AL, Niculet E, Olaru I, Manole C, Olaru F, Mihailov OM, Guliciuc M, Beznea A, Bușilă C, Candussi IL, Moroianu LA, Stănculea FC. Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation. Life (Basel) 2023; 13:1916. [PMID: 37763319 PMCID: PMC10532963 DOI: 10.3390/life13091916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION The Buschke-Löwenstein tumor (BLT) is an uncommon sexually transmitted ailment attributed to the human papillomavirus (HPV)-usually the 6 or 11 type (90%)-with male predominance and an overall infection rate of 0.1%. BLT or giant condyloma acuminatum is recognized as a tumor with localized aggressiveness, displaying distinctive features: the potential for destructive growth, benign histology, a rate of 56% malignant transformation, and a high rate of recurrence after surgical excision. There are several treatment choices which have been tried, including laser, cryotherapy, radiotherapy, electrocoagulation, immunotherapy, imiquimode, sincatechins, intralesional injection of 5-fluoruracil (5-FU), isolated perfusion, and local or systemic chemotherapy. In the case of an extensive tumor, preoperative chemotherapy or radiotherapy is used for tumor shrinkage, making the debulking procedure safer. HPV vaccines significantly decrease the incidence of genital warts, also decreasing the risk of BLT; HPV-6 and HPV-11 are included in these vaccines. MATERIALS AND METHODS We present a 53-year-old heterosexual man, hospitalized in our department in June 2021 with a typical cauliflower-like tumor mass involving the perianal region, which progressively increased in size for almost 7 years. The perianal mass was completely removed, ensuring negative surgical margins. The large perianal skin defect which occurred was reconstructed with fascio-cutaneous V-Y advancement flap. There was no need for protective stoma. The literature review extended from January 1980 and December 2022, utilizing Pubmed and Google Scholar as search platforms. RESULTS Due to the disease's proximity to the anal verge and the limited number of reported cases, arriving at a definitive and satisfactory treatment strategy becomes challenging. The optimal approach entails thorough surgical removal of the lesion, ensuring well-defined surgical margins and performing a wide excision to minimize the likelihood of recurrence. In order to repair the large wound defects, various rotation or advancement flaps can be used, resulting in reduced recovery time and a diminished likelihood of anal stricture or other complications. Our objective is to emphasize the significance of surgical excision in addressing BLT through the presentation of a case involving a substantial perianal condyloma acuminatum, managed successfully with complete surgical removal and the utilization of a V-Y advancement flap technique. In the present case, after 5 months post operation, the patient came back with a buttock abscess, which was incised and drained. After another 5 months, the patient returned for difficult defecation, with an anal stenosis being diagnosed. An anal dilatation and sphincterotomy were carried out, with good postoperative results. CONCLUSIONS The surgical management of Buschke-Löwenstein tumors needs a multidisciplinary team with specialized expertise. The reconstruction techniques involved can be challenging and may introduce additional complications. We consider aggressive surgery, which incorporates reconstructive procedures, as the standard treatment for Buschke-Löwenstein tumors. This approach aims to achieve optimal surgical outcomes and prevent any recurrence.
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Affiliation(s)
- Raul Mihailov
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Alin Laurențiu Tatu
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Dermatology Department, Saint Parascheva Infectious Diseases Clinical Hospital, 800179 Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University of Galați, 800201 Galați, Romania
| | - Elena Niculet
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Iulia Olaru
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Corina Manole
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Florin Olaru
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Oana Mariana Mihailov
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
| | - Mădălin Guliciuc
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Adrian Beznea
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- Clinical Emergency County Hospital Sf. Ap. Andrei, 800578 Galați, Romania; (I.O.); (F.O.)
| | - Camelia Bușilă
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Iuliana Laura Candussi
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Lavinia Alexandra Moroianu
- Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800008 Galati, Romania; (R.M.); (A.L.T.); (E.N.); (A.B.); (C.B.); (I.L.C.); (L.A.M.)
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Chang KC, Chen YC, Ding DC. Condyloma acuminatum mimicking cervical cancer in a pregnant woman and treatment with cryotherapy: A case report. Medicine (Baltimore) 2022; 101:e32273. [PMID: 36626521 PMCID: PMC9750563 DOI: 10.1097/md.0000000000032273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
RATIONALE Condyloma acuminata and anogenital warts are protruding papillomatous lesions caused by human papillomavirus. In pregnant women, condyloma acuminata over the cervical region may grow rapidly, mimicking cervical cancer. PATIENT CONCERNS A pregnant woman at 14 weeks of gestation with condyloma acuminatum mimicking cervical cancer was referred to our hospital for further management. DIAGNOSIS Condyloma acuminata. INTERVENTIONS Tumor biopsy was performed twice, and the pathology confirmed condyloma acuminatum. Immunohistochemistry revealed focal positivity for p16 and Ki-67. Cryotherapy was performed and regular follow-up was performed at 2-week intervals. A small residual condyloma acuminata was found and treated with cryotherapy. OUTCOME During the follow-up period, no recurrence of condyloma acuminata was noted. She delivered a baby at 37 weeks of gestation via cesarean section, without complications. LESSONS Condyloma acuminata of the cervix may grow faster during pregnancy, mimicking cervical cancer. Multiple factors must be considered when treating condyloma acuminata during pregnancy. Cryotherapy is proposed as a 1st-line treatment in all trimesters because of its safety, convenience, and cost-effectiveness. Serial follow-up at 2-week intervals to observe post-cryotherapy conditions is recommended.
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Affiliation(s)
- Kai-Chieh Chang
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan ROC
| | - Yen-Chang Chen
- Department of Anatomical Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan ROC
- Department of Pathology, School of Medicine, Tzu Chi University, Hualien, Taiwan ROC
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan ROC
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan ROC
- * Correspondence: Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, No. 707, Chung-Yang Rd., Sec. 3, Hualien 970, Taiwan ROC (e-mail: )
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Brahmana IB, Inayati I. Massive Condyloma Acuminata on a 20-week Pregnant Primigravida. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND OF THE STUDY: Condyloma acuminata, a sexual infectious disease caused by Human Papilloma Virus (HPV) or Chlamydia trachomatis is more commonly in pregnant women and severe than in non-pregnant women. Pregnant women are susceptibility to infection due to the immunologic suppression and continues according to gestational age.
AIM OF THE STUDY: Delivering a case report about a primigravida diagnosed with massive condyloma acuminata.
METHODOLOGY: A 27-year old primigravida, 20 weeks gestation age with clinical manifestation of massive condyloma acuminata. In speculo, cauliflower-like masses in vaginal into cervix , intact, livide and grandson cervix, a lot of vaginal discharge/flour albus from ostium uteri externum. Vaginal swab and serology test for Chlamydia was conducted.
RESULTS: The patient was treated by cauterization and clinical manifestations after cauterization was observed until delivered. Termination at 37 weeks gestation age , aterm , estimated fetal weight > 2500 grams by cesarean section. Improvement of healing process without new tissue pasca cauterization. CONCLUSION: The cauterization conducted on a 27-year old primigravida, 20 weeks gestation age with a massive condyloma acuminata showed a clinical recovery result and finally the pregnancy was terminate by cesarean section at the 37 weeks and > 2500 grams fetus weight safely.
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Jin S, Liu L, Li R, Zhou X, Wang Z, Luan C, Chen K, Huang D. A rare case of self-healing giant condyloma acuminatum. Dermatol Ther 2021; 35:e15189. [PMID: 34729875 DOI: 10.1111/dth.15189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022]
Abstract
Giant condyloma acuminatum (GCA) which is also called Buschke-Lowenstein tumor. It is a rare tumor of the anorectal area and external genitalia associated with low-risk HPV types 6 or 11. GCA has a high-rate of recurrence (66%) and malignant transformation (56%). The clinical features of GCA are progression of exophytic, ulcerative, and cauliflower-shaped tumors, it has significant dimensions and may undergo malignant transformation such as squamous cell carcinoma or cervical cancer. It is difficult to treat GCA, and it may be impossible for GCA to self-healing, but we herein report a rare case of a 19-year-old female with self-healing GCA.
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Affiliation(s)
- Shuang Jin
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Linxi Liu
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Rong Li
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xuyue Zhou
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ziwei Wang
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Chao Luan
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Kun Chen
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Dan Huang
- Department of Physiotherapy, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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Riethmuller D, Buisson A, Thong Vanh C, Istasse F, Valmary-Degano S, Michy T, Hoffmann P. [Giant condyloma acuminatum in pregnancy]. ACTA ACUST UNITED AC 2021; 50:201-204. [PMID: 34403829 DOI: 10.1016/j.gofs.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Indexed: 10/20/2022]
Abstract
Buschke Lownestein's tumour is a giant acuminate condyloma characterised by its degenerative potential, its invasive nature and its recurrence after treatment. It is a rare condition, transmitted mainly by sexual transmission and induced by to the human papillomavirus (HPV). The discussion will be illustrated by a clinical case The treatment is still under discussion but surgery seems to be the best option. Management during pregnancy is more complex since it must take into account the mother and her fetus. The delivery route is still debated. The post-treatment evolution was satisfactory and without recurrence until the delivery which, due to the antecedent of 3 caesarean sections, was carried out by cesarean section. HPV vaccination, sex education and early treatment of condyloma lesions should prevent and in any case improve the prognosis of this disease.
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Affiliation(s)
- D Riethmuller
- Département de GO et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France.
| | - A Buisson
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - C Thong Vanh
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - F Istasse
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - S Valmary-Degano
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - T Michy
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
| | - P Hoffmann
- Service d'anatomie et cytologie pathologique, département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble Alpes, 38700 La Tronche, France
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Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage. Infect Dis Obstet Gynecol 2021; 2021:9919446. [PMID: 34305393 PMCID: PMC8266468 DOI: 10.1155/2021/9919446] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
Giant condyloma acuminatum (GCA) or Buschke-Loewenstein tumor is a rare disease, with an estimated prevalence of 0.1%. It was initially described in 1896 by Buschke and later in 1925 by Buschke and Loewenstein. Classic condyloma acuminata (CCA) and squamous cell carcinoma (SCC) were initially described as different entities. These three entities are currently considered to correspond to the same spectrum of different but not exclusive malignant transformations, associated with multiple risk factors such infection by human papilloma virus (HPV), immunodeficiencies, poor hygiene, multiple sexual partners, and chronic genital infections. HPV subtypes 6 and 11 are associated with 90% of GCA. It presents as a cauliflower-like tumor in the genital region with bad odor, bleeding, and local infection, differential diagnosis with multiple conditions should be considered, and sexually transmitted diseases should always be investigated. GCA has a higher rate of malignant transformation than CCA and tends to infiltrate adjacent soft tissues. The therapeutic approach is controversial but is considered that the resection with free edges is the gold standard and can be combined with adjuncts. The recurrence rate is high. Overall mortality is 21% and is associated with morbidity caused by recurrences. Imiquimod cream 5% has recently shown good results as monotherapy and in combination with ablative and surgical treatments. The quality of life is diminished in patients with this condition. In this review, we address the different aspects of this rare entity including the therapeutic approach.
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Wang MF, Lin L, Li LF. Efficacy and Safety of Giant Condyloma Acuminatum with Monotherapy of Topical Traditional Chinese Medicine: Report of Eight Cases. Infect Drug Resist 2021; 14:1375-1379. [PMID: 33859483 PMCID: PMC8043789 DOI: 10.2147/idr.s302195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Giant condyloma acuminatum (GCA), also called Buschke-Löwenstein tumor, presents as a verrucous infiltrating lesion and is caused by sexual transmission of human papilloma virus. The optimal treatment is controversial and there are no standard guidelines because of its rarity and frequent recurrence. It has a relatively high local recurrence rate. Objective We here report eight patients (six men and two women) with GCA whose lesions were successfully treated topically with traditional Chinese medicine (TCM) preparations, paiteling. Methods and Materials We administered topical TCM preparations to eight patients diagnosed with GCA who had refused surgery. The treatment process included three stages, their durations depending on the speed of resolution of the lesions and the results of visual inspection with acetic acid. Results No significant complications occurred in any patient. The functional and esthetic outcomes were satisfactory. No recurrences were detected during follow-up. Conclusion Topical treatment with TCM preparations may be a good alternative to surgery or other traditional methods for the treatment of GCA. This treatment has the advantages of being non-invasive, painless, and having a low risk of recurrence, and may be a useful adjunct to mainstream medical treatments.
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Affiliation(s)
- Mei-Fang Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Li Lin
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Lin-Feng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
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11
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Photodynamic therapy combined with surgical management of extensive anogenital condylomatosis in a patient with systemic lupus erythematosus. Photodiagnosis Photodyn Ther 2020; 31:101881. [PMID: 32562734 DOI: 10.1016/j.pdpdt.2020.101881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/31/2020] [Accepted: 06/15/2020] [Indexed: 11/20/2022]
Abstract
Infections with human papillomavirus in the anogenital area result in warty, papillary, and condylomatous lesions. The giant anogenital wart is relatively uncommon. Treatment of giant wart is challenging, especially in the immunosuppressive population. Here, a patient with systemic lupus erythematosis had extensive, fast-growing, recurrent anogenital condylomatosis shaped as giant cauliflowers. We reported this case and the successful treatment of photodynamic therapy combined with surgical management. It provided the feasibility for surgical ablation combined with ALA-PDT performed for these kinds of challenging cases.
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Cui T, Huang J, Lv B, Yao Q. Giant condyloma acuminatum in pregnancy: A case report. Dermatol Ther 2019; 32:e12972. [PMID: 31141268 PMCID: PMC6771555 DOI: 10.1111/dth.12972] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 01/01/2023]
Abstract
The giant condyloma acuminatum (GCA), also known as Buschke-Löwenstein tumor (BLT), is a type of human papilloma virus-associated sexually transmitted infection. Treatment options for condyloma acuminatum remain controversial, but surgery seems to be the best option. The management of GCA during pregnancy is more complicated since one has to evaluate the condition of both the mother and the fetus. In this report, we presented a GCA case in a pregnant woman with giant masses that covered the perineal and perianal region. Considering the gestational age and the fetal neurological risk from the anticipated lengthy procedure of mass removal surgery for tumor of this size, we decided to resect the tumor 2 weeks after the infant was delivered via C-section.
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Affiliation(s)
- Tao Cui
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jingwen Huang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Bin Lv
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Qiang Yao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
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