Successful surgical management of giant condyloma acuminatum (Buschke-Löwenstein tumor) in the genitoanal region: a case report and evaluation of current therapies.

Giant condyloma acuminatum (GCA; Buschke-Lowenstein 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 para-rectum. 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.