Case of Giant Condyloma Acuminatum of Buschke- Löwenstein

CLINICAL-IMAGE

An 89-year-old patient, does not report the notion of unprotected sexual intercourse, treated for years by touching with trichloroacetic acid for genital warts, presenting a budding mass extending from the pubis to the glans evolving for 2 years. Clinical examination revealed an exophytic budding ulcerating 7 cm tumor, papillomatous in perineal cauliflower with damage to part of the glans, fetid and painless (Figure 1). Dermoscopic examination showed a papillomatous appearance, keratin, and polymorphic vascularity surrounded by whitish halos (Figure 2). The lymph nodes were free. The HIV, syphilitic and hepatitis B and C serologies were negative. The histological examination of a biopsy sample revealed an epitheliomatous hyperplasia made of an acanthosic, papillomatous malpighian coating, overcome by a parakeratotic hyperkeratosis with presence of koilocyte, no cellular atypia was noted (Figure 3). The diagnosis of Buschke-Löwenstein tumor was accepted and the patient was referred to the urological surgery department for possible surgical intervention.

Buschke-Löwenstein tumour (BLT), also known as Giant condyloma acuminatum, is a very rare, sexually transmitted disease that affects the ano-genital region whose frequency is estimated at 0.1% of the general population with a male predominance [1-3]. BLT was first described by Buschke and Lowenstein in 1925 [4]. BLT is a slow growing cauliflower-like tumour, but unlike simple condyloma, it is locally aggressive and destructive [5]. Human papillomavirus (HPV) has been identified as an important contributory factor in the development of tumour. DNA corresponding to 6 and 11 HPV subtypes has been frequently identified in typical cauliflower-like lesions, suggesting the pathogenic role of the virus in the initiation and progression of the tumour [6-7]. The risk of recurrence and degenerescence is very important. The main treatment is surgical excision. Sex education and early treatment of condylomatous lesions improve the prognosis.

REFERENCES

  1. Balik E, Eren T, Bugra D (2009) A surgical approach to anogenital Buschke Loewensteintumours (giant condyloma acuminata). Acta Chir Belg 109(5): 612-616.
  2. Erkek E, Basar H, Bozdogan O, Emeksiz MC (2009) Giant condyloma acuminata of Buschke-Löwenstein: successful treatment with a combination of surgical exci-sion, oral acitretin and topical imiquimod. Clin Exp Dermatol 34(3): 366-368.
  3. Miranda Aranzubía O, García Rodríguez J, González Alvarez RC, AlvarezMújica M, Rodríguez Robles L, et al. (2008) Giant condyloma acuminatum (Buschke-Löwenstein tumor). Actas Urol Esp 32(9): 951.
  4. Loewenstein LW (1939) Carcinoma-like condylomata acuminate of the penis. Med Clin N Am 23 (3): 789-795.
  5. Talwar A, Puri N, Singh M (2010) Giant condyloma acuminatum of Buschke and Low-enstein: successful surgical treatment. Int J STD AIDS 21(6): 446-448.
  6. Tripoli M, Cordova A, Maggì F, Moschella F (2012) Giant condylomata (Buschke-Löwenstein tumours): our case load in surgical treatment and review of the current therapies. Eur Rev Med Pharmacol Sci 16(6): 747- 751.
  7. Braga JC, Nadal SR, Stiepcich M, Framil VM, Muller H (2012) Buschke-Loewensteintumor: identification of HPV type 6 and 11. An Bras Dermatol 87(1): 131-400.

Article Type

Clinical Image

Publication history

Received date: January 09, 2020
Published date: January 24, 2020

Address for correspondence

Selma Benkirane, Department of Dermatology, University Hospital Hassan II, Fez, Morocco

Copyright

©2020 Open Access Journal of Biomedical Science, All rights reserved. No part of this content may be reproduced or transmitted in any form or by any means as per the standard guidelines of fair use. Open Access Journal of Biomedical Science is licensed under a Creative Commons Attribution 4.0 International License

How to cite this article

Selma B, Mounia B, Sara E, Zakia D, Hanane B, Fatima Zahra M. Case of Giant Condyloma Acuminatum of Buschke-Löwenstein. 2020 - 2(1) OAJBS. ID.000134.

Author Info

Selma Benkirane*, Mounia Bennani, Sara Elloudi, Zakia Douhi, Hanane BayBay and Fatima Zahra Mernissi

Department of Dermatology, University Hospital Hassan II, Fez, Morocco

Figure 1: Clinical examination of the perineal tumor extending to the glans.

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Figure 2: Dermoscopic examination showed a papillomatous appearance, keratin, and polymorphic vascularity surrounded by whitish halos.

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Figure 3: The histological examination revealing an epitheliomatous hyperplasia with presence of koilocyte, without cellular atypia.

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