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Perianal and Anal Canal Neoplasms
Published in Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens, Neoplasms of the Colon, Rectum, and Anus, 2007
Although there is no universal agreement, there is a growing consensus of opinion that the entity that has been termed a “giant condyloma acuminatum” or a “Buschke–Löwenstein tumor” represents a verrucous carcinoma. Similar to anal warts, verrucous carcinoma is associated with HPV-6 and -11. These lesions typically present as large (8 × 8 cm), slow growing, painful, wart-like growths that are relatively soft and have a cauliflower-like appearance. The lesions may arise in the perianal skin, anal canal, or distal rectum and are frequently indistinguishable from condylomata acuminata. Although they are histologically benign, their behavior is clinically malignant. The clinical course of these lesions is one of relentless progression and expansion of the neoplasm by extensive erosion and pressure necrosis of surrounding tissues with invasion of the ischioanal fossa, perirectal tissues, and even the pelvic cavity. The invasive nature of these lesions may cause multiple sinuses or fistulous tracts, which may invade fascia, muscle, or the rectum and may cause inflammation, infection, and hemorrhage. The extent of involvement can be precisely determined by CT examination. Microscopically, the lesions bear a marked resemblance to condylomata acuminata with papillary proliferation, keratinization, acanthosis, parakeratosis, and vacuolization of superficial layers. Metastasis from these tumors has not been reported to date (88,89).
Perianal condylomata and anal intraepithelial neoplasia
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
Tim W Eglinton, Frank a Frizelle
Condylomata may be asymptomatic, but can cause perianal itch, moistness, swelling, and occasionally bleeding. Examination reveals elevated, cauliflower-like pink lesions, which may form larger plaques (Figure 2.14.1). It is important to accurately determine the extent of the disease because warts may be present within the anal canal and on the external genitalia. The Buschke-Lowenstein tumor is a giant condyloma acuminatum which is a locally aggressive lesion requiring surgical excision.
Retinoids in Other Skin Diseases
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Uwe Wollina, Piotr Brzezinski, André Koch
A 15-year-old boy with recalcitrant giant condylomas was treated with a combination of 25 mg acitretin/day and Mycobacterium indicus pranii vaccination immunotherapy. Complete clearance was obtained after 6 months of acitretin with no recurrence within the next 2 years of follow-up (74). A 16-year-old girl with HPV-6-positive giant condyloma acuminatum was cured by a combination of intramuscular interferon-gamma 1 MIU/day and oral acitretin 30 mg/day after 3 months of treatment (75).
Psychological aftermath of giant genital warts in a “victim” of the anti-immunisation trend
Published in Journal of Obstetrics and Gynaecology, 2022
Anastasios Liberis, Georgios Pratilas, Roxani Dampali, Anastasia Vatopoulou, Stamatios Petousis, Alexios Papanikolaou
Giant condyloma acuminatum, also known as a Buschke–Löwenstein tumour, is a rare cutaneous condition characterised by an aggressive, wart-like growth that displaces and destroys adjacent structures. These masses are mostly benign, but the potential for malignant transformation to squamous cell carcinoma exists in the long term. Buschke-Löwenstein tumours are frequently associated with HPV subtypes 6 and 11 and as a result the 4-valent and 9-valent HPV vaccines offer significant protection (Sandhu et al. 2014).