CASE REPORTS   

Chirurgia 2013 April;26(2):137-40

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Perianal giant condyloma acuminatum (Buschke-Lowenstein tumor): report of 3 cases

Leone V., Misuri D., Giovane A., Console N., De Chiara A., Faggi U.

Department of General Surgery St. Maria Nuova Hospital, Florence, Italy

Perianal giant condyloma acuminatum (Buschke-Lowenstein tumour) is a rare variant of condyloma acuminatum and is a potentialy fatal disease. His hallmark is high propensity for local recurrence and malignant degeneration. This malignant potential is showed comparing the incidence of malignant transformation of perianal condyloma acuminatum: 1,8% versus 52-55% of giant condyloma acuminatum. The therapy has not been standardized because of the rarity of this entity and because of there are no randomised controlled trials published on its treatment. Traditionally, surgical resection has been the treatment of choice, but has resulted in a high local recurrence rate. Instead it is well documented that the topical application of podophyllin, interferon, 5-fluorouracil and so on, that worked well in the ordinary condyloma acuminatum yielded poor results for giant condyloma acuminatum. We report 3 cases (2 males, 57 and 51-year-old, heterosexual and 1 female 45-year-old with sexual promiscuity) of perianal giant condyloma acuminatum with invasive squamous-cell carcinoma treated by surgical excision alone. One male refused postoperative neoadjuvant therapy and follow-up. The female showed local recurrence after 10 months and we performed new surgical excision and at present, after 14 months, there is not recurrence.