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Vol. 218, No. 1, 2009
Issue release date: December 2008
Dermatology 2009;218:56–59

Successful Surgical Management of Giant Condyloma Acuminatum (Buschke-Löwenstein Tumor) in the Genitoanal Region: A Case Report and Evaluation of Current Therapies

Gholam P. · Enk A. · Hartschuh W.
Department of Dermatology, University of Heidelberg, Heidelberg, Germany

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Giant condyloma acuminatum (GCA; Buschke-Löwenstein tumor) is a human-papillomavirus-induced cauliflower-like tumor of the genitoanal region. It is characterized by its size, capability of local infiltration and high recurrence rate. We report on a 50-year-old patient presenting with a maximum finding of GCA with deep infiltration into the adductor and perineal musculature, the scrotum, the penis and the pararectum. After performing a temporary loop colostomy, the tumor was removed by wide radical excision following plastic reconstruction with a myocutaneous gracilis flap. During a follow-up period of more than 5 years, no recurrence developed. Many treatment strategies (e.g. chemotherapy, radiation) have been published in the literature. Most authors recommend the radical surgical excision, allowing a complete histological examination and assessment of tumor-free resection margins. Despite the benign histological pattern of GCA in most cases, transformations into verrucous carcinoma and squamous-cell carcinoma have been described. In our case, the GCA seems to represent a continuum between normal condyloma acuminatum and an initial verrucous carcinoma.

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