Buschke-Löwenstein肿瘤(BLT),也被称为巨大尖锐湿疣,是一种罕见的,外生性肿瘤,由与人乳头瘤病毒(HPV)感染相关的预先存在的疣性病变引起,特别是菌株6和11,它们被认为具有低致癌潜力。BLT作为一个大的,花椰菜样生长通常影响阴茎,外阴,阴道,会阴,阴囊,肛门,和肛周区域。尽管是良性病变,BLT是局部侵袭性的,复发率高,并可能发生恶性转化为鳞状细胞癌,导致20-30%的总死亡率。主要的治疗方法是广泛的手术切除,经常需要复杂的重建技术来覆盖缺陷。我们报道了一个68岁的病人,有多种合并症,他在生殖器区域有两年的大型外生性肿瘤病史,影响阴茎,伴随进行性勃起功能障碍和泌尿问题。手术切除了肿瘤的安全边缘,使用阴囊和完整阴茎皮肤的前移和旋转皮瓣进行重建。组织病理学检查证实了巨大尖锐湿疣(Buschke-Löwenstein肿瘤)的诊断,显示棘皮病,乳头状瘤病,角化不全,和古细胞集合,p16,p63和ki67的免疫组织化学染色阳性。术后,该患者具有良好的临床疗效和完全的手术治愈。该病例强调了治疗巨大尖锐湿疣的及时干预和综合管理策略的迫切需要,鉴于其潜在的局部入侵和对患者生活质量的重大影响。早期诊断和彻底的手术切除对于有效治疗和减少高复发率至关重要。与这种情况相关的发病率和恶性转化风险。
The Buschke-Löwenstein tumor (BLT), also known as giant condyloma acuminatum, is a rare, exophytic tumor, arising from pre-existing warty lesions associated with human papillomavirus (HPV) infection, particularly strains 6 and 11, which are considered to have low oncogenic potential. BLT presents as a large, cauliflower-like growth typically affecting the penis, vulva, vagina, perineum, scrotum, anus, and perianal area. Despite being a benign lesion, BLT is locally aggressive with a high recurrence rate, and can potentially undergo malignant transformation into squamous cell carcinoma, contributing to an overall mortality rate of 20-30%. The primary treatment is complete surgical excision with wide margins, frequently requiring complex reconstructive techniques for defect coverage. We report on a 68-year-old patient, with multiple comorbidities, who presented with a two-year history of a large exophytic tumor in the genital region, affecting the penis, along with progressive erectile dysfunction and urinary problems. The tumor was surgically excised with oncological safety margins, and reconstruction was performed using advancement and rotation flaps from the scrotum and intact penile skin. Histopathological examination confirmed the diagnosis of Giant Condyloma (Buschke-Löwenstein tumor), showing acanthosis, papillomatosis, parakeratosis, and koilocytic cell collections, with positive immunohistochemical staining for p16, p63, and ki67. Postoperatively, the patient had a good clinical outcome and a complete surgical cure. This case highlights the critical need for timely intervention and comprehensive management strategies in treating giant condyloma, given its potential for local invasion and substantial impacts on patient quality of life. Early diagnosis and thorough surgical excision are crucial for effective management and to reduce the high recurrence, morbidity and malignant transformation risk associated with this condition.