Should the Surgical Management of Buschke-Lowenstein Tumors Be Aggressive? About 10 Cases.

AIMS: Buschke-Lowenstein tumor (BLT) of the anal margin is a histologically benign tumor whose degeneration can lead to a deadly local evolution because of difficult and late diagnosis. The objective of this study was to report our experience and propose a therapeutic strategy for these rare tumors. METHODS: From 1996 to 2014, 10 men with a median age of 45 years (25-64) were treated for a BLT of the anal margin with a first local excision possibly followed by rectal amputation. RESULTS: Local perianal excision was curative in 6 cases without recurrence. The median follow-up time was 94.5 months (5-175). In 4 patients, local excision was followed by an early recurrence, justifying a complementary abdominoperineal excision (APE) of the rectum. Two patients who benefited from complementary resection are currently free from recurrence. Even if the postoperative course was uneventful, 2 died from recurrence and disease progression within 5 and 11 postoperative months each. CONCLUSION: Macroscopic surgical evaluation of local tumoral invasion and extensive radical resection appears to be associated with long-term survival without recurrence. When recurrence occurs, APE of the rectum seems to be the only curative alternative. Based on low level of evidence, surgical excision is currently the only standard treatment for these lesions.

A rare retrorectal presentation of a bronchogenic cyst: A case report.

INTRODUCTION: Bronchogenic cysts are rare abnormalities and a retrorectal presentation is exceptional. Its natural history is not known, but malignant transformation is quite rare. Retrorectal bronchogenic cysts are usually asymptomatic. PRESENTATION OF THE CASE: We present the case of a 36-year-old young man with a past medical history of HIV seropositivity who underwent a procedure to excise a sacral coccyx cyst at another surgical center in February 2009. A histological examination confirmed it was a sacral cyst that was resected in sano. The patient presented with a recurrence of the cyst, and this report describes the combined surgical procedure using a double sacrococcygeal and abdominal approach. DISCUSSION: A complete excision without cyst rupture is recommended to reduce the risk of local recurrence and malignant transformation, as previously reported. Resection can ben performed using multiple approaches depending on the cyst's location CONCLUSION: Herein, we report the case of a retrorectal bronchogenic cyst in a 36 years old man who was initially treated for a pilonidal cyst. A double surgical approach (abdominal and Kraske) resulted in complete resectioning with no reccurrence.