Tumor de Buschke ­ Löwenstein: Presentación de un Caso y Revisión Bibliográfica / Buschke ­ Löwenstein Tumor: A Case Report and Review of the Literature

Introducción: El tumor de Buschke ­ Lowenstein (TBL) es enfermedad de transmisión sexual causada por el virus del papiloma humano (VPH), descrita como una forma intermedia entre un condiloma acuminado y un carcinoma de células escamosas. Afecta principalmente al área genital y anorrectal, posee capacidad de transformación maligna y una alta tasa de recurrencia. La cirugía es el tratamiento de primera línea. Caso clínico: Presentamos el caso de un paciente masculino de 27 años con lesiones verrucosas de crecimiento progresivo en el área inguinal y genital. Mediante la correlación clínico-patológica se llegó al diagnóstico de TBL. Tras discusión en comité multidisciplinario se declaró irresecable y se resolvió tratamiento con radioterapia, además vacunación terapéutica contra el VPH, tanto sistémica como intralesional. Conclusión: El TBL es localmente agresivo y de difícil tratamiento, por lo que la prevención contra el VPH es fundamental. La vacunación terapéutica en conjunto con la radioterapia ofreció mejoría clínica.

Introduction: Buschke-Lowenstein tumor (BLT) is a sexually transmitted disease caused by the human papillomavirus (HPV), described as an intermediate form between condyloma acuminata and squamous cell carcinoma. It mainly affects the genital and anorectal areas and has the capacity for malignant transformation and a high recurrence rate. Surgery is the first-line treatment. Clinical case: We present the case of a 27-year-old male patient with warty lesions of progressive growth in the inguinal and genital areas. Through the clinical-pathological correlation, the diagnosis of BLT was reached. After discussion in a multidisciplinary committee, it was declared unresectable, and treatment with radiotherapy was resolved, in addition to therapeutic vaccination against HPV, both systemic and intralesional. Conclusion: BLT is locally aggressive and challenging to treat, so prevention against HPV is essential. Therapeutic vaccination in conjunction with radiotherapy offered clinical improvement.

Case report: Buschke-Löwenstein tumor in a non-immunosuppressed patient

The present work aims to report a case of Buschke-Löwenstein tumor (BLT), which is a mass of genital warts that usually affects immunosuppressed people. The reported case was diagnosed in a young patient with no known immunosuppression. Several tests were performed to confirm the diagnostic hypothesis, including immunohistochemistry, histological, molecular and imaging analysis. The results obtained were confirmatory in all analyses, except in the molecular one. Because BLT is a rare condition, there is still great literary heterogeneity regarding the ideal treatment, but some options can be considered, such as excision and radiotherapy. (AU)

Buschke-Lowenstein tumor in a patient with HIV and Psoriasis / Tumor de Buschke-Lowenstein em um paciente com HIV e psoríase

Abstract The Buschke-Lowenstein tumor, known as the giant condyloma acuminatum, is a rare lesion of the anorectal and PerianaL region; it is sexually transmitted and associated with human papilloma virus, types 6 and 11. Histologically, it is a benign tumor, but it can reach big proportions and may behave aggressively. The purpose of this study is to report the case of a patient diagnosed with HIV and psoriasis 14 years ago, associated with Buschke-Lowenstein tumor and other diffuse condylomatous lesions in the body.

Resumo O tumor de Buschke-Lowenstein, também conhecido como condiloma acuminado gigante, é uma lesão rara da região anorretal e perianal, sexualmente transmitida, associada ao papiloma vírus humano, Tipos 6 e 11. Histologicamente, trata-se de um tumor benigno, mas clinicamente atinge grandes proporções e pode se comportar de forma agressiva. O objetivo deste estudo é relatar o caso de um paciente com diagnóstico de HIV e psoríase há 14 anos, associado ao tumor de Buschke-Lowenstein e outras lesões condilomatosas difusas no corpo.

Giant condylomata acuminata of Buschke-Lowenstein: Surgical method as effective treatment and Imiquimod as adjuvant therapy in an immunocompetent patient / Condiloma acuminado gigante de Buschke-Lowenstein: Método cirúrgico como tratamento eficaz e Imiquimode como terapia adjuvante em uma paciente imunocompetente

Introduction: Giant condylomata acuminata, also known as Buschke-Lowenstein tumor is a rare form of tumor of the anogenital condylomata acuminata, which is a sexually transmitted infection (STI) caused by the human papillomavirus (HPV). Objective: To report a case of giant condylomata acuminata in an immunocompetent patient. Case report: The patient was referred to the Outpatient Clinic for Sexually Transmitted Infections and AIDS at a public hospital in the city of Vitória, Espírito Santo State, Brazil, reporting the onset of progressive growth verrucous lesions on the external genitalia for four months. The patient underwent surgical ablation, and giant condylomata diagnostic confirmation was obtained through histopathology. She was treated with 5% imiquimod cream in routine applications for eight consecutive weeks to avoid recurrence and was also vaccinated for HPV after the procedure. Conclusion: Surgery excision is the treatment of choice in extensive genital condylomata lesions to exclude malignancy. Imiquimod use as adjuvant therapy for reducing recurrence seems to be adequate.

Introdução: O condiloma acuminado gigante, também conhecido tumor de Buschke-Lowenstein, é uma apresentação rara do condiloma acuminado anogenital, que é uma infecção sexualmente transmissível (IST) causada pelo papilomavírus humano (HPV). Objetivo: Relatar um caso de condiloma acuminado gigante em uma paciente imunocompetente. Relato de caso: A paciente foi encaminhada para o ambulatório de infecções sexualmente transmissíveis e AIDS de um hospital público na cidade de Vitória, Espírito Santo, Brasil, relatando o aparecimento de lesões verrucosas de crescimento progressivo na genitália externa por quatro meses. A paciente foi submetida à exérese cirúrgica e a confirmação diagnóstica de condiloma gigante foi obtida através da histopatologia. Ela foi medicada com imiquimode creme a 5% em aplicações rotineiras por oito semanas consecutivas para evitar recorrências e foi também vacinada contra o HPV após o procedimento. Conclusão: Exérese cirúrgica é o tratamento de escolha em lesões condilomatosas extensas para excluir malignidade. O uso de Imiquimode como terapia adjuvante para redução de recidivas mostrou-se adequado.

Tumor de Buschke-Löwenstein. presentación de un caso / Tumor de Buschke-Löwenstein. apresentação de um caso / uschke-Löwenstein tumor. case report

Se presentó un paciente masculino de 68 años, que acudió a consulta de Dermatología por presentar lesiones vegetantes en coliflor en región inguinal izquierda, pubis y perineales, de 10 años de evolución y nunca tratadas. El tumor de Buschke-Löwenstein o condiloma acuminado gigante es una tumoración epitelial benigna, causada por el virus del papiloma humano, trasmisible sexualmente, en raros casos puede malignizar. Se realizó escisión quirúrgica y estudio histopatológico de la lesión inguinal, las restantes lesiones fueron eliminadas con ácido tricloroacético, tratamiento tópico, logrando regresión total de las mismas y se le administró levamisol, inmunomodulador sistémico. La evolución posquirúrgica fue satisfactoria(AU)

A male patient of 68 years was presented who consulted Dermatology to present vegetating and cauliflower lesions in the left inguinal, pubic and perineal region, 10 years of evolution and never treated. Tumor of Buschke-Löwensteinor giant condyloma is a benign epithelial tumor is caused by the human papillomavirus, sexually transmitted and in rare cases can become it in malignant. Surgical excision and histopathological examination of the inguinal lesion was done, the remaining lesions were removed with trichloroacetic acid, topical treatment, achieving complete regression thereof and administered levamisole and systemic immunomodulator. The postoperative course was satisfactory(AU)

Paciente do sexo masculino, 68 anos, apresentou-se aoServiço de Dermatologiadevido a lesões vegetantes nacouve-flor naregião inguinal esquerda, púbis e períneo, comduração de 10 anose nunca tratadas. O tumor de Buschke-Löwenstein ou o condiloma acuminado gigante é um tumor epitelial benigno, causado pelo papilomavírus humano sexualmente transmissível, podendo, em casos raros, malignizar. Excisãocirúrgica e estudo histopatológico da lesão inguinal foram realizados, as lesõ es remanescentesforam eliminadas com ácido tricloroacético, tratamento tópico, obtendoregressão total das mesmas e foi administrado levamisol, imunomodulador sistêmico. A evoluçãopós-operatória foi satisfatória(AU)

Tumor de Buschke-Löwenstein - Condiloma gigante acuminado / Buschke-Löwenstein's Tumor - Giant Condyloma Acuminatum

Presentamos el caso de un hombre de 21 años de edad, infectado por el virus de la inmunodeficiencia humana (VIH) que presenta lesiones verrucosas gigantes compatibles con un tumor de Buschke-Lowenstein (TBL) que afectaban la región perineal, anorrectal y genitales externos. También existía afectación del párpado superior derecho. (AU)

We report the case of a 21-year-old male patient, infected with human immunodeficiency virus (HIV) that presents giant warty lesions compatible with a Buschke-Lowenstein tumor (BLT) that affected the perineal, anorectal and external genital region. He also had a right upper eyelid lesion. (AU)

Tumor de Buschke-Löwenstein: relato de três casos / Buschke-Löwenstein Tumor: report of three cases

O tumor de Buschke-Löwenstein é uma doença rara, de transmissão sexual, associada ao papilomavírus humano, principalmente dos subtipos 6 e 11. Caracteriza-se como uma lesão exofítica, em forma de couve-flor, de progressão lenta, com alto poder de infiltração local. O seu principal fator de risco é a imunossupressão e o tratamento geralmente é cirúrgico, com ou sem terapias adjuvantes. O impacto na vida da paciente é grande, com altas taxas de recorrência após excisão cirúrgica. Relatamos 3 casos de condiloma gigante com achados histopatológicos diversos, com graus de infiltração e papilomatose variados.

The Buschke-Löwenstein Tumor is a rare, sexually transmitted disease, triggered by human papillomavirus, specially the subtypes 6 and 11. It is characterized as a cauliflower-shape exophytic mass, slowly progressive, with high local recurrence rates and high infiltration. The main risk factor is immunosuppression. Surgical treatment is usually preferred, with or without adjuvant therapy. It has a great impact on the patients' life, impairing their life quality. We report three cases of Giant Condyloma with diverse histopathological findings with varying degrees of infiltration and papillomatosis.

Verrucous carcinoma of the vulva: diagnosis and treatment

Abstract: Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Lesions present in the form of a verrucous, ulcerated, and bleeding tumor that can reach large dimensions. This type of tumor can be mistaken for condylomata, both macroscopically and microscopically. We report the case of an 81-year-old patient with a large vulvar tumor presented for eight years, initially considered as a Buschke-Löwenstein tumor. The patient underwent radical vulvectomy with a V-Y advancement flap technique. This type of tumor should be considered by clinicians dealing with condylomatous ulcerative lesions that do not respond to the usual treatment.

Giant Condyloma (Buschke-Loewenstein Tumor) in a 16-year-old Patient: Case Report / Condiloma gigante (tumor de Buschke-Loewenstein) em uma paciente de 16 anos: relato de caso

Abstract The Buschke-Loewenstein tumor is characterized by excessive growth of verrucous lesions on the genitals and/or perianal region. It is considered benign despite the high rate of recurrence and the possibility of malignant transformation. It is commonly associated with subtypes 6 and 11 of the human papillomavirus (HPV), and host 's immunity plays an important role in the development of the disease. Surgical excision is the recommended treatment in most cases. We present the case of a 16 years old female patient with extensive vulvar lesions successfully treated surgically.

Resumo O tumor de Buschke-Loewenstein se caracteriza pelo crescimento excessivo de lesões verrucosas na região genital e/ou perianal. É considerado benigno apesar da elevada taxa de recorrência e da possibilidade de transformação maligna. Está comumente associado aos sorotipos 6 e 11 do papiloma vírus humano (HPV) e a imunidade do hospedeiro tem importante papel no desenvolvimento da doença. A excisão cirúrgica é o tratamento recomendado na maioria dos casos. Apresentamos o caso de uma paciente do sexo feminino, de 16 anos, com lesão vulvar de grande extensão tratada cirurgicamente com sucesso.

Giant condyloma acuminatum: report of surgical treatment and evolution of healing / Condiloma acuminado gigante: relato de tratamento cirúrgico e evolução da cicatrização

O condiloma acuminado gigante, variante rara do condiloma acuminado anogenital, apresenta crescimento rápido associado a estados de imunodeficiência.Relatamos os resultados com os cuidados com a ferida operatória. Trata-se de homem de etnia negra, 55 anos, portador do vírus da imunodeficiência humana com condiloma acuminado acometendo desde as regiões inguinais até o sulco interglúteo, que foi ressecado permanecendo a ferida aberta para posterior enxertia. Os cuidados com essa ferida incluíram solução de polihexametileno biguanida/betaína, solução de ácidos graxos essenciais, hidrofibra/prata e película. Evoluiu com infecção secundária sendo a hidrofibra substituída por espuma de poliuretano/prata/ibuprofeno. Houve melhora da infecção e da dor, contração das bordas e presença de tecido de granulação em toda a lesão. Naquelas condições, o enxerto de pele foi realizado no 41º dia. A despeito dos possíveis vieses de confusão, pode-se inferir que esses cuidados prepararam o leito da ferida para receber o enxerto de pele.

Giant condyloma acuminatum, a rare variant of anogenital condyloma, shows rapid growth associated with immunodeficiency. Wound care after resection andoutcomes were reported. NGS, black, 55 years, HIV positive, with giant condyloma acuminatum affecting from the groin to the intergluteal groove, which wasresected, remaining the wound opened for later skin graft. Topical care included polihexametilene biguanide/betaine solution, essencial fatty acids solution,hydrofiber/silver, and poliuretane film. The wound developed secondary infection, so hidrofiber was replaced by polyurethane foam/silver/ibuprofen. Therewas improvement in infection and pain, contraction of the edges and the presence of granulation tissue across the lesion. In those conditions the skin graft was performed after 41 days. Despite possible confusion bias, it can be inferred that the care adopted prepared the wound bed to receive the skin graft.

Reconstrucción perineal inmediata en extensa resección abdominoperineal rectal / Immediate perineal reconstruction after vast rectal abdominoperineal resection

Background: Buschke-Lowenstein tumor is a benign skin lesion secondary to human papilloma virus infection. It usually appears as an exophytic anogenital mass and may progress to a squamous cell carcinoma. It can be treated with chemo, radio or immunotherapy and occasionally it requires radical surgery. Case report: We report a 53 years old male with a perianal lesion lasting 15 years that was treated with chemo-radiotherapy that relapsed with malignant transformation. Since the pathological study showed a squamous cell carcinoma, a rectal abdominoperineal resection was planned. The defect that left the surgical procedure was covered with musculocutaneous flaps from gracilis muscle of the thigh.

Introducción: El tumor de Buschke-Lõwenstein es una lesión cutánea benigna, secundaria a la infección por virus papiloma humano, usualmente se presenta como una gran masa exofítica genitoanal y tiene riesgo de evolucionar a carcinoma espinocelular. Dentro de su tratamiento existen varias alternativas, desde menos agresivas como quimio-radioterapia e inmunoterapia, que suelen tener alta tasa de recidiva, hasta la cirugía radical. Caso clínico: Presentamos el caso de un paciente masculino, con una lesión perianal de 15 años de evolución, inicialmente se sometió a terapias locales conservadoras y quimiorradioterapia y posteriormente recidivó con transformación maligna. Habiéndose confirmado histológicamente la presencia de carcinoma espinocelular, debió abordarse mediante una resección abdominoperineal rectal. Dicha cirugía determinó un gran defecto de cobertura perianal y perineal que fue reparado mediante colgajos músculo-cutáneos de gracilis y fasciocutáneos de muslo. Discusión: Si bien se han descrito algunos métodos de resección local, sólo la cirugía radical permite su eliminación completa disminuyendo el riesgo de recurrencia. Ello genera un defecto perianal de difícil manejo, para el cual existen varias opciones reconstructivas: injertos, colgajos locales y regionales, y, con menor frecuencia, colgajos libres. Se debe considerar que en aquellos defectos de gran tamaño, con gran pérdida de tejido, las opciones de reconstrucción del defecto con volumen y cobertura cutánea adecuada son limitadas. Presentamos nuestra experiencia con algunas de estas técnicas, entre las que destaca el colgajo de músculo gracilis, con los múltiples beneficios que posee.

Electrocautery Resection, Shaving with a Scalpel, and Podophyllin: a Combination Therapy for Giant Condyloma Acuminatum

Giant condyloma acuminatum (also known as Buschke-Lowenstein tumor) is a rare disease, for which the treatment of choice is still controversial. In the case described in this report, we used a combination of electrocautery and a surgical scalpel to resect a huge genital wart, followed by long-term local treatment with podophyllin. This procedure was relatively fast, easy to perform, involved minimal bleeding, and did not result in any complications. Moreover, combination therapy enabled us to avoid deep resection of the lesion and consequently, sexual function was preserved completely.

Buschke-Loewenstein tumor: a case series from Brazil / Tumor de Buschke-Loewenstein: uma série de casos brasileira

Buschke-Loewenstein Tumor or giant condyloma acuminatum is a disease caused by a DNA virus, the self-inoculable human papilloma virus (HPV), being sexually transmitted. Histologically BLT is a benign tumor, but with malignant clinical behavior and a high propensity for local recurrence and malignant degeneration. The clinical picture consists of the presence of a cauliflower-like bulky condylomatous perianal mass with multiple fistulous tracts, which can cause great destruction of the anal canal, with invasion of adjacent tissues. Bleeding, foul odor, local pain and weight loss are also described. The diagnosis is established by biopsy, that should exclude the presence of malignant transformation, which occurs in 30-50% of cases. Associated with a biopsy, the hybridization test may be performed to diagnose HPV infection, especially subtypes 6 and 11, that are commonly related. The treatment of choice is radical surgical excision; however, those patients presenting with extensive fistulous lesions may require a temporary colostomy. Some authors advocate an abdominoperineal resection in cases of infiltration of the sphincter or rectum. This study was designed to evaluate the experience of the service of Coloproctology at a referral hospital in Northeastern Brazil with this rare entity, contributing to world literature in addressing this disease. (AU)

Tumor de Buschke-Loewenstein ou condiloma acuminado gigante é uma doença causada por um vírus de DNA, o papilomavírus humano (HPV), auto-inoculável, sendo transmi-tido sexualmente. Histologicamente, são tumores benignos, porém, de comportamento clínico maligno, apresentando alta propensão à recorrência local e a degeneração maligna. O quadro clínico consiste na presença de uma volumosa massa condilomatosa perianal, com aspecto de couve-flor, com numerosos trajetos fistulosos, podendo provocar grande destruição do canal anal e invasão dos tecidos adjacentes. Sangramento, odor fétido, dor local e perda ponderal são também descritos. O diagnóstico é feito por biópsia, que deve afastar a presença de transformação maligna, que ocorre em 30-50% dos casos. Associado à biópsia, pode ser realizado um teste de hibridização para diagnosticar a infecção por HPV, principalmente os subtipos 6 e 11 que são comumente relacionados. O tratamento de escolha é a excisão cirúrgica radical, entretanto, os pacientes que apresentam lesão extensa com fístula, podem requerer colostomia temporária. Alguns autores advogam a amputação abdominoperineal do reto nos casos de infiltração dos esfíncteres ou do reto. O estudo foi designado para se avaliar a experiência do serviço de coloproctologia de um hospital de referência no Nordeste brasileiro com esta rara entidade, contribuindo com a literatura mundial na abordagem desta enfermidade. (AU)

Buschke–Lowenstein Tumor in a Human Immunodeficiency Virus Positive Patient: A Rare Case Report.

Buschke–Lowenstein tumor, otherwise known as giant condyloma acuminata, presents as an asymptomatic, papillomatous growth on the genitalia or the perianal area that grows to a large size. A 28 year old male HIV seropositive patient presented to outpatient department clinic with complaint of large painfull mass in pubic, peno-scrotal & anogenital region with pus, bleeding and fetid odour since 1 year Histopathological examination revealed hyperkeratosis, parakeratosis, acanthosis & papillomatosis. A wide surgical excision was performed with removal of 80% of tumor and for rest of the tumor podophyllin 20% was prescribed.

Condiloma acuminado gigante (tumor de Buschke-Lowenstein) / Giant condyloma acuminatum (Buschke-Lowenstein tumor)

Se presenta un paciente masculino de 72 años de edad de la raza blanca, que es remitido al Servicio de Coloproctología por presentar desde hace más de un año, aumento de volumen alrededor del ano que le dificulta la defecación y sentarse. Se han realizado múltiples tratamientos tópicos con resultados no satisfactorios por el servicio de dermatología. Se le realiza estudio histopatológico de la lesión y se obtuvo un condiloma acuminado gigante (tumor de Buschke-Lowenstein). Se ha dado seguimiento sin presentarse hasta el momento recurrencia. El tumor de Buschke-Lowenstein es una entidad rara, considerada una lesión premaligna provocada por el papiloma virus humano. Hasta el momento no se ha podido encontrar el tratamiento ideal y continúa presentando una alta tasa de recurrencia(AU)

This case report presented a 72 years-old Caucasian patient, who was referred to the Coloproctology Service because of increased volume around his anus that made it difficult for him to defecate and to sit down. He had followed several topical treatments prescribed by the dermatology service with unsatisfactory results. The lesion was histopathologically studied and the final diagnosis was giant condyloma acuminatum (Buschke-Lowenstein tumor). The patient was followed up and no recurrence has been so far observed. Buschke-Lowenstein tumor is a rare entity, being considered as a premalignant lesion caused by human papillomavirus. The ideal treatment ha not been yet found and it remains a disease of high rate of recurrence(AU)

Giant Condyloma Acuminatum of the Anorectum : Surgical or Topical Treatment.

Giant condyloma (Buschke-Loewenstein tumour) is a rare disease that commonly affects the urogenital area. We encountered an eighteen year old, nonhomosexual, HIV negative, male, who presented with a cauliflower like warty mass around perianal region. The mass was 8×6 cm in size, circumferential, soft and papillary in nature. Wide excision of mass was carried out with anoplasty reconstruction. Post-operatively, wound healing was uneventful. After wound healing, the topical applications of five percent imiquimod were done regularly under the care of dermatologist for three months. At six months of follow-up, patient is free from tumour, and is having neither signs of anal stenosis nor incontinence.

Condiloma acuminado gigante (tumor de Buschke Lowenstein): serie de 7 casos clínicos y revisión de la literatura / Giant condylomata acuminata (Buschke - Lowenstein tumor). series of 7 cases and literature review

El condiloma gigante acuminado (Tumor de Buschke-Lowenstein) es una rara enfermedad que afecta frecuentemente a pacientes inmunodeprimidos, presenta un alto porcentaje de malignización, tasa de recidiva y mortalidad. Existe poco consenso respecto de su tratamiento y controles post-operatorios, donde juegan un importante papel los estudios imagenológicos, existiendo escasa literatura al respecto. En la presente revisión, presentamos los casos de 7 pacientes, junto con sus características fundamentalmente en resonancia magnética como también en tomografía computada, además de realizar una revisión de la literatura. En general se observan lesiones exofíticas pediculadas en "coliflor". A la tomografía computada presentan densidad de partes blandas y vascularización. En resonancia magnética son isointensas en T1, levemente hiperintensas en T2, restringen a la difusión y captan heterogéneamente el medio de contraste paramagnético, manteniendo su realce en fases tardías.

Giant condyloma acuminata (Buschke - Lowenstein tumor ) is a rare disease that commonly affects immunocompromised patients, presenting a high percentage of malignancy, recurrence rate and mortality. There is little consensus regarding treatment and post-operative controls, where imaging studies play an important role, existing sparse literature regarding this. In this review, we present the cases of seven patients, along with their characteristics mainly on MRI as well as CT scan, in addition to a revision of the literature. In most cases, pedunculated exophytic "cauliflower-like" lesions are observed. Which are of soft-tissue density and vascularized. In magnetic resonance imaging they are isointense on T1, slightly hyperintense on T2, with restricted diffusion on DWI, and heterogenous enhancement on gadolinium administration, with a late progressive enhancement pattern.

Buschke-lowenstein tumor in a 45-year old male: A case report

Buschke-Lowenstein tumor(BLT) is a rare sexually transmitted disease triggered by human papillomavirus type 6 or 11. It presents as an anogenital exophytic tumor characterized by its size, local infiltration, high recurrence rate and risk of malignant transformation to squamous cell carcinoma. A 45-year-old heterosexual male presented with a 22-year history of slow-growing, multiple, dark brown, verrucous, exophytic nodules and plaques over the trunk, extremities, inguinal and gluteal areas. Two years prior to consult, there was coalescence of lower abdominal plaques with rapid growth of a pinkish cauliflower-like tumor. Pelvic MRI showed that the tumor was limited to the skin. Biopsy of the lower abdominal mass was consistent with BLT and positive for HPV DNA. There was no internal organ involvement or metastasis. Pulsed dye and erbium:YAG lasers were done on the gluteal area test sites followed by wide excision and split-thickness skin graft of the lower abdominal and pubic area.

Condiloma anal gigante: relato de caso / Giant condyloma acuminatum: a case report

O tumor de Buschke-Löwenstein é uma variedade pouco frequente da infecção pelo HPV. O tumor possui comportamento invasivo, embora seja histologicamente benigno. Pode estar associado a condições de imunossupressão e a recorrência após o tratamento é frequente. Objetivo: descrever um caso de um portador de aids e demonstrar que a imunossupressão é fator contribuinte, e que a cirurgia é o tratamento mais eficaz. Métodos: descrição do caso clínico, com referências na literatura. Resultados: foi realizada a cirurgia com ressecção ampliada e evolução satisfatória no pós-operatório.Conclusão: a cirurgia é o tratamento recomendado pela maioria dos autores e a biópsia é procedimento indicado para excluir malignidade.

Buschke-Löwenstein tumor is an uncommon variety of HPV infection. Being histologically benign, the tumor has invasive behavior. It maybe associated with conditions of immunosupression, and recurrence after treatment is frequent. Objective: to describe a case in a patient with AIDS, to show that immunosupression is a contributing factor, and that surgery is the most effective treatment. Methods: a case description, with references in the literature. Results: extended resection surgery with satisfactory outcome in the postoperative period. Conclusion: surgery is the treatment recommended by most authors and biopsy is an indicative procedure to exclude malignancy.

A Case of Verrucous Carcinoma Arising on the Anogenitalia of Young Woman / 대한피부과학회지

Verrucous carcinoma is a slowly-growing, well-differentiated, low grade squamous cell carcinoma with little tendency to metastasize. There have been several case reports of this tumor but its occurrence at a young age is extremely rare. Herein we report a case of verrucous carcinoma arising on the anogenitalia of a young woman with pancytopenia.