Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Sep 16:11:231.
doi: 10.1186/1477-7819-11-231.

Buschke-Löwenstein tumor with squamous cell carcinoma treated with chemo-radiation therapy and local surgical excision: report of three cases

Marileda Indinnimeo  1 , Alessio Impagnatiello, Gabriella D'Ettorre, Gloria Bernardi, Cosima Maria Moschella, Paolo Gozzo, Antonio Ciardi, Caterina Bangrazi, Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Affiliations
Case Reports

Buschke-Löwenstein tumor with squamous cell carcinoma treated with chemo-radiation therapy and local surgical excision: report of three cases

Marileda Indinnimeo et al. World J Surg Oncol. .

Abstract

Treatment of anorectal Buschke-Löwenstein tumor (BLT) with squamous cell carcinoma (SCC) transformation is not univocal given the rarity of the disease. BLT is characterized by its large size and tendency to infiltrate into underlying tissues. Malignant transformation can occur and it is important to identify the presence of neoplastic foci to decide the proper treatment. Our aim was to assess the effectiveness of neo-adjuvant chemo-radiation therapy (CRT) and local excision in order to avoid abdomino-perineal resection (APR). Three cases of anorectal BLT with SCC transformation are presented. All patients were HIV positive and treated with antiretroviral drugs. They underwent preoperative endoanal ultrasound, biopsies, total body tomography and anal brushing. Treatment consisted of neo-adjuvant chemo-radiation therapy (45 Gy to the pelvis plus a boost with 14.40 Gy to the primary tumor for a total of 59.40 Gy, and mitomycin-C in bolus on the first day, plus 5-fluorouracil by continuous infusion in the first and in the sixth week) and subsequent local surgical excision. During the follow-up, patients were subjected to the same preoperative diagnostic investigations and high resolution anoscopy. All patients showed a complete regression of the lesion after CRT and were treated by local surgical excision, thus avoiding permanent colostomy. In conclusion neo-adjuvant chemo-radiation therapy with local surgical excision could be considered an effective therapy in the treatment of anorectal BLT with SCC transformation to avoid APR.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preoperative appearance of the patient with a perianal cauliflower-like tumor. The lesion appears exophytic and infiltrates the perianal tissue.
Figure 2
Figure 2
Perineum after chemo-radiation therapy and local excision. The lesion has completely disappeared after chemo-radiation and local excision was subsequently performed.
Figure 3
Figure 3
Endoanal ultrasound (US) showing the tumor invasion of the anal canal. Endoanal US allowed completion of the staging and showed the degree of infiltration thus staging the tumor as uT2.
Figure 4
Figure 4
Endoanal ultrasound (US) after treatment. It is evident a complete regression of the anal tumor.
See this image and copyright information in PMC

References

    1. Rhea WG, Bourgeois BM, Sewell DR. Condyloma acuminatum: a fatal disease. Am Surg. 1998;64(11):1082–1087. - PubMed
    1. Klein N, Jasch K, Kimmritz J, Hermes B, Harth W. Operative therapy of a monstrous Buschke-Löwenstein tumor. Dermatology. 2007;215(3):264–265. doi: 10.1159/000106589. - DOI - PubMed
    1. Chu QD, Vezeridis MP, Libbey NP, Wanebo HJ. Giant condyloma acuminatum (Buschke-Löwenstein tumor) of the anorectal and perianal regions. Analysis of 42 cases. Dis Colon Rectum. 1994;37(9):950–957. doi: 10.1007/BF02052606. - DOI - PubMed
    1. Bogomoletz WV, Potet F, Molas G. Condyloma acuminata, giant condyloma acuminatum (Buschke-Lowenstein tumor) and verrucous squamous carcinoma of the perianal and anorectal region: a continuous precancerous spectrum? Histopathology. 1985;9:1155–1169. doi: 10.1111/j.1365-2559.1985.tb02796.x. - DOI - PubMed
    1. Longacre TA, Kong CS, Welton ML. Diagnostic problems in anal pathology. Adv Anat Pathol. 2008;15(5):263–278. doi: 10.1097/PAP.0b013e318183234b. - DOI - PubMed

Publication types

MeSH terms