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Buschke-Löwenstein Tumor in an Immunodeficient Patient – a Case Report and Review of Treatment Possibilities


Authors: M. Králová;  D. Švecová
Authors‘ workplace: Dermatovenerologická klinika LF UK a UN Bratislava-Staré Mesto, prednostka prof. MUDr. Mária Šimaljaková, PhD.
Published in: Čes-slov Derm, 89, 2014, No. 6, p. 270-274
Category: Case interpretation

Overview

Buschke-Löwenstein tumor, condyloma acuminata gigantea, is a very rare STI caused by HPV viruses (Human Papilloma Virus), mainly low-risk HPV 6 and 11. Tumor is characterized by a huge slowly growing cauliflower mass in anogenital region with invasive and destructive potential. Recurrence after treatment is very common. Primary or secondary immunodeficiency is the risk factor of Buschke-Löwenstein tumor development. The diagnosis is based on a typical clinical picture of a huge tumor mass with bleeding, effusion or fistulas. The histological evaluation reveals no typical signs of malignancy. The treatment guidelines do not exist, the local cytodestructive and immunomodulatory treatment is not efficient. The surgical intervention is preferred in cases with well developed features of the disease. Combination therapy might be also effective. Authors report a case of 44-year-old man with secondary immunodeficiency due to chronic inflammatory condition, namely bone tuberculosis, and chronic alcoholism. The patient suffered from giant genital warts in scrotal and perianal area. Histopathological examination revealed no signs of malignancy. Genetic-molecular methods (RT-PCR; Real Time Polymerase Chain Reaction) confirmed low risk HPV 6. The patient was successfully treated with surgery and subsequently with topical 5% imiqumod and metizoprinol systematically for several months. One-year follow-up was without recurrence.

Key words:
Buschke-Löwenstein tumor – condylomata acuminata gigantea – low-risk HPV 6, 11 – immunodeficiency – therapy of Buschke-Löwenstein tumor


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Dermatology & STDs Paediatric dermatology & STDs
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