An uncommon type of well-differentiated squamous cell carcinoma is the verrucous carcinoma of the skin and mucosa. When squamous carcinoma is present in the genital region of the body, it is known as the Buschke-Lowenstein tumor. Buschke-Lowenstein tumor or giant condyloma acuminatum is a rare cutaneous condition. It is characterized; by the development of a wart-like aggressive verrucous carcinoma. It is attributed to the human papillomavirus.
These tumors can be both locally destructive and invasive. In general, masses of Buschke-Lowenstein tumors are benign but there is a high potential for its transformation into a malignant form from a benign one in the long term, as does the rare risk for metastasis. Buschke-Lowenstein tumors usually displace and destroy adjacent structures as a result of compression. These tumors are most of the time associated with HPV subtypes 6 and 11. Close follow-up is crucial due to the high recurrence rates of the tumor.
Buschke Lowenstein Tumor Symptoms
The signs and symptoms of Buschke-Lowenstein tumor or giant condyloma acuminatum involve the development of a cauliflower-shaped mass around the region of the external genitals and abscess or fistula around the growing mass. Due to this cauliflower-shaped mass growth, the affected individuals also experience severe pain in the mass area and psychological distress. These tumors can grow up to twenty centimeters. It is diagnosed; by methods such as imaging studies and microscopic exams of a small piece of tumor tissue.
Although it is known about Bushcke-Lowenstein tumors that these are slow-growing, these pain-causing tumors can easily invade the surrounding tissues of the genital region and cause damage as a result. These tumors do not eradicate easily and appear back even after the surgical operation. However, these tumors usually do not spread to other parts of the body. It depends on the size of the Buschke-Lowenstein tumor, long-term outcome for patients, and response to treatment.
Buschke Lowenstein Tumor Causes
Buschke-Lowenstein tumors (BLT) are caused; by a specific type of human papillomavirus (HPV). HPV infections occur when the virus enters the body through an abrasion, cut, or small tear in the skin. A few HPV infections are due to upper or oral respiratory lesions contracted through oral sex. HPV infections are due to anal sex, sexual intercourse, and other skin-to-skin contact in the genital portion.
The HPV virus can also cause contagious warts. These can spread through direct contact with a wart. The human papillomavirus can affect individuals through sexual contact. However, not all the affected individuals with the human papillomavirus will develop a Buschke-Lowenstein tumor. This tumor may also develop due to other reasons despite the sexual contact only. Some other factors responsible for the Buschke-Lowenstein tumor may include alcoholism, diabetes, and a weak immune system.
Buschke Lowenstein Tumor Radiology
Buschke-Lowenstein tumor or Giant condyloma acuminatum is a rare variety of venereal warts characterized by a locally invasive and large-sized tumor. The radiological findings enable the specialists in diagnosing the presence of this tumor in the human body. The CT scan of two patients with anorectal giant condylomata revealed the invasive nature of the lesion and the extent of the tumor. Papillomatous, perirectal fascial planes, infiltration of the subcutaneous tissue, and luminal narrowing with marked thickening of the rectal wall were also observed.
However, the pathologic specimens of the affected individuals’ tumors depicted benign histologic findings in one case and a mixed pattern with areas of malignant degeneration in the other. The Computed Tomography Scan demonstrated the exact site location and extent of the growth of cauliflower-shaped mass
and to which extent the lesions are present. Remarks regarding malignant degeneration in this inherently invasive lesion can only be established based on histologic examination.
Buschke Lowenstein Tumor Treatment
The treatment of choice for Buschke-Lowenstein or the giant condyloma acuminatum includes a wide surgical excision to eradicate the tumor and surrounding tissue around the affected body region. Chemotherapy may also be used to remove this tumor depending upon the size and spread of this tumor. It has been reported that 45.5% of patients have been declared disease-free patients due to surgical treatment only. However, controlled trials comparing the other methods of treatment are currently lacking.
A few factors that need consideration while opting for the treatment for Buschke-Lowenstein tumors. These may involve the size and thickness of the lesions, anatomic location, cost, provider, availability, and quantity. It also depends on HPV classification, patient’s preferences, and immunocompromised or immunocompetent status. There is no current treatment that can contribute to the complete eradication of HPV. Specialists like oncologists, surgeons, psychologists, or plastic surgeons are involved in treating individuals affected with Buschke-Lowenstein tumors.