Papiu H S, Dumnici A, Olariu T, Onita M, Hornung E, Goldis D, Aiordachioae G, Vasca V
"Vasile Goldiş" Western University Arad, Department of Surgery, Romania.
Chirurgia (Bucur). 2011 Jul-Aug;106(4):535-9.
Giant condyloma acuminatum, also known as Buschke-Löwenstein tumor (BLT) is a very rare sexually transmitted disease that affects the ano-genital region. BLT is a slow growing cauliflower-like tumor, but unlike simple condyloma, it is locally aggressive and destructive, malignant transformation occuring in 40-60% of cases. We present a case of perianal carcinomatous BLT and discuss some controversies about the nature and treatment of this disease. Our aim is to emphasize some basic points in the management of giant perianal condyloma acuminatum.
The patient with BLT must be very carefully clinical and imagistic investigated in order to detect the tumor visceral invasion and to establish the extension of the surgical procedure. Wide perineal excision with histopathological margins control is the best surgical choice if the anal canal is not involved. The radical pelvic surgery is indicated only in patients with provable visceral invasion. Excision is mandatory even in very small condilomas to prevent BLT later development.
巨大尖锐湿疣，也称为Buschke-Löwenstein肿瘤（BLT），是一种非常罕见的性传播疾病，累及肛门生殖器区域。BLT是一种生长缓慢的菜花状肿瘤，但与单纯尖锐湿疣不同，它具有局部侵袭性和破坏性，40%-60%的病例会发生恶性转化。我们报告一例肛周癌性BLT病例，并讨论有关该疾病性质和治疗的一些争议。我们的目的是强调巨大肛周尖锐湿疣管理中的一些基本要点。
对于BLT患者，必须进行非常仔细的临床和影像学检查，以检测肿瘤的内脏侵犯并确定手术范围。如果肛管未受累，广泛会阴切除并进行组织病理学切缘控制是最佳手术选择。仅在有可证实的内脏侵犯的患者中才考虑进行根治性盆腔手术。即使是非常小的尖锐湿疣也必须切除，以防止后期发展为BLT。
