Buschke-Lowenstein tumor is also called giant condyloma acuminatum or giant condyloma of Buschke and Lowenstein. The tumor generally appears in the anogenital region, mostly on the penis, but it can be localized in the perianal area, or be found on the scrotum, perineum, vulva, vagina or bladder. A case of its occurrence in the urethra with the bladder unaffected has also been described in a female patient [1]. Some authors regard it a version of wart-like, verrucous carcinoma, which is itself a variant of squamous cell carcinoma. Others [2] consider it an intermediate between condyloma acuminatum (genital warts caused by human papillomavirus) and squamous-cell carcinoma.

Its appearance is usually described as a cauliflower-like, exophytic growth, although it infiltrates local tissues and therefore sometimes shows exo-endophytic growth pattern [3]. It is a slow growing tumor, but if not treated, can grow to a large size and ulcerate the penis; if it involves the perianal region, it can cause bleeding and abscesses. Growth may be faster in immunocompromised patients.

The appearance of the tumor may suggest an aggressive nature; however, the histologic pattern is benign [3]. Nevertheless, the tumor needs careful attention because of its large size and the high probability of recurrence [4] [5]. There is also a marked tendency for malignant transformation to squamous cell carcinoma [2] [5] [6] [7], although metastases are very infrequent. Thus, removal of the Buschke-Lowenstein tumor is regarded as imperative to avoid the above risks [8]. Regular follow-up is also necessary.

Several investigators have reported an association between the presence of human papillomavirus (HPV) types 6 and 11, which have a low potential for malignant transformation, and Buschke-Lowenstein tumor [9] [10] [11] [12]. Some investigators believe the association may indicate a causal relationship [6], others regard this as unsubstantiated [10], yet others suggest possible roles for coinfecting HPV viruses 16 and 18 which have higher oncogenic potential [9]. Thus, the role of HPV in Buschke-Lowenstein tumor has not been resolved.

• Aspiration

  Fine-needle aspiration of an inguinal lymph node demonstrated metastatic squamous cell carcinoma (SCC). In situ hybridization for HPV genotypes 16 and 18 was negative, although other genotypes were not tested. [ascopubs.org]

• Xanthoma

  Verruciform xanthoma of the vulva: Case report. Genitourin Med 1989;65:252-4. Cheng SF. Seborrheic keratosis of penis. Urology 1974;3:595-7. Friedman SJ, Fox BJ, Albert HL. Seborrheic keratoses of penis. Urology 1987;29:204-6. [ijstd.org]

• Follicular Plugging

  Diagnosis becomes more difficult in the genital region as the features of distinct keratotic and follicular plugging, stuck-on appearance disappear because of the friction and maceration typical of this area. [ijstd.org]

• Dizziness

  The patient’s other symptoms included anemia, episodes of dizziness, and a 50-lb weight loss over the previous 6 months. Physical findings included bitemporal atrophy, pallor, brittle nails, and an atrophic tongue. [mdmag.com]

• Headache

  Most recently, she also noted extreme headaches, hematuria, and cloudy, foul-smelling urine. [karger.com]

• Hematuria

  Most recently, she also noted extreme headaches, hematuria, and cloudy, foul-smelling urine. [karger.com]

A biopsy is essential for diagnosis. The biopsy must be wide and deep to allow for finding possible squamous cell carcinoma foci and to assess the extent of infiltration into an underlying tissue. The base of the tumor displays blunt-shaped tumor cell aggregates that extend deeply into the dermis. It is this deep endophytic growth and the thick stratum corneum that distinguishes the Buschke-Lowenstein tumor (BLT) from condyloma acuminatum. Vacuole formation occurs in both diseases [13].

Further characteristics of BLT are hyperkeratosis, parakeratosis, papillomatosis, acanthosis, and koilocytosis. The tumor may show infiltration by lymphocytes [6]. Displacement of tissues by the tumor is also a frequent feature of BLT. Most of these traits also occur in verrucous carcinoma; thus, distinguishing BLT from verrucous carcinoma is difficult [13]. Magnetic resonance imaging using gadolinium-diethylenetriamine pentaacetic acid (DTPA) contrast is helpful in establishing the boundaries of the tumor. Computed tomography scan has been used to examine local invasion by BLT [13].

Sentinel lymph node biopsy should be performed if there is a need for its examination. Human papillomavirus has been identified by in situ hybridization, polymerase chain reaction and restriction fragment length polymorphism [9] [12] [13] [14].

Early diagnosis and treatment are advised and the choice of treatment is crucial. We present a case of a 31-year-old pregnant woman with myasthenia gravis affected by Buschke-Lowenstein tumor. [ncbi.nlm.nih.gov]

Others treatments proposed are radiotherapy, chemotherapy, interferon, iniquimod and so on. Other studies are requested to value the best treatment. [iris.unito.it]

Post-treatment clinical monitoring is highly recommended. [omicsonline.org]

Bottom, After 12 months of treatment, the internal obturator muscle is again well defined (arrow). Figure 3. [jamanetwork.com]

The treatment is based on surgery, but relapses are very frequent. [scidoc.org]

Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma, for which the prognosis is worse. [morebooks.de]

In majority of the cases, the prognosis is excellent with appropriate treatment. [dovemed.com]

Appropriate treatment of GCA provides very good prognosis and low rate of recurrence. Prognosis is specifically considered good with adequate surgical excision [ 10 ]. [omicsonline.org]

Giant condylomata acuminata (Buschke-Lowenstein tumor) of the penis resembles carcinoma in some respects but has a favorable prognosis. [jamanetwork.com]

A viral etiology suggests it should be more common in the immunocompromised; however, few reports exist in the literature. The evaluation, treatment, and role of preventative measures are reviewed. [ncbi.nlm.nih.gov]

Viruses, unclean sanitation and cytotoxic immune reaction have been proposed as the etiology of the tumor. However, among all the causes, recent studies have emphasized on the associaton of the tumor and human papilloma virus (HPV). [synapse.koreamed.org]

Its etiology is human pappiloma virus. It occurs more in men than women with a ratio of 2.7:1. Immunosuppresssion with HIV is the main risk factor but it has also been associated with pregnancy, diabetes, chronic steroid use and organ transplants. [ajol.info]

Etiology Pathophysiology VC is a low-grade well-differentiated variant of squamous cell carcinoma of the mucosa and skin that was first described by Ackerman in 1948. [infectiousdiseaseadvisor.com]

PVL lacks specific histological criteria, so epidemiology, clinical presentation, and histopathology must all be taken into account for diagnosis. [infectiousdiseaseadvisor.com]

Epidemiology of mucosal human papillomavirus infection and associated diseases. Public Health Genomics 2009;12:291-307. 2. Aubin F, Prétet JL, Jacquard AC, Saunier M, Carcopino X, Jaroud F, et al. EDiTH Study Group. [idoj.in]

The epidemiology of GCA is more common in males at a 3.5:1 ratio and two thirds of cases are reported in patients under 50 years old [ 7 ]. [karger.com]

Giant condyloma acuminatum of the anorectum: trends in epidemiology and management: report of a case and review of the literature. Dis Colon Rectum. 2001;44:1878-86. Montaña N, Labra A, Schiappacasse G. [revista.fecolsog.org]

Etiology Pathophysiology VC is a low-grade well-differentiated variant of squamous cell carcinoma of the mucosa and skin that was first described by Ackerman in 1948. [infectiousdiseaseadvisor.com]

From the *Dermatology and Venereology Unit, Department of Pathophysiology and Organ Transplantation, University of Milan Medical School, Milan, Italy; †Fondazione IRCCS, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; and ‡Divisions of Urology [journals.lww.com]

Cutaneous Continent Urinary Diversion 459 Orthotopic Urinary Diversion 465 Genital and Lower Urinary Tract Trauma 468 Lower Urinary Tract Calculi 471 Development Molecular Biology and Physiology of the Prostate 476 Benign Prostatic Hyperplasia Etiology Pathophysiology [books.google.de]

The evaluation, treatment, and role of preventative measures are reviewed. [ncbi.nlm.nih.gov]

The evaluation, treatment, and role of preventative measures are reviewed. A report and discussion of rare scrotal Buschke-Lowenstein tumor in the immunocompromised patient. The evaluation, treatment, and potential role of prevention are discussed. [journals.lww.com]

Find out the causes, diagnosis, risk factors, treatment and preventive steps from this article Are you looking to overcome a cancer diagnosis without toxic drugs or surgery? Ruby Lathon talks to Jonathan Landsman about how to heal the body naturally. [pinterest.de]

Immediate circumcision should be carried out in all males with phimotic foreskins who develop verruca acuminata in this area in order to prevent the development of this lesion. [jamanetwork.com]

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