Correia Estefânia, Santos António
Family Practice Unit of Pedras Rubras, Rua Divino Salvador de Moreira 160, 4470-105 Maia, Portugal.
Department of Dermatology, Portuguese Institute of Oncology, Portugal.
Case Rep Dermatol Med. 2015;2015:651703. doi: 10.1155/2015/651703. Epub 2015 Aug 31.
We report a case of an 80-year-old female who presented with a four-year history of a growing mass in the perianal area with pain and bleeding during defaecation. Clinical examination revealed a locally destructive, cauliflower-like, verrucous mass measuring 10 × 12 cm in diameter. Histologic findings revealed a moderate degree of dysplasia of the epithelium with koilocytosis atypia, acanthosis, and parakeratosis, features that are consistent with Buschke-Löwenstein tumour. Polymerase-chain-reaction assay for human papillomavirus (HPV) showed an infection with HPV type 11. Full-thickness excision of involved skin was undertaken by cryotherapy and electrocautery over five months. The entire wound was left open to heal by secondary intention. After 3 years of follow-up, the patient has not experienced a recurrence, with excellent functional results, but the cosmetic results were satisfactory. These minimally invasive techniques can be safer and more cost-effective than surgery and the General Practitioner can play a key role in diagnosis.
我们报告一例80岁女性病例，该患者肛周区肿物增大4年，排便时伴有疼痛和出血。临床检查发现一个直径为10×12 cm、局部浸润性生长的菜花状、疣状肿物。组织学检查发现上皮呈中度发育异常，伴有挖空细胞异型性、棘层肥厚和角化不全，这些特征符合Buschke-Löwenstein肿瘤。人乳头瘤病毒（HPV）聚合酶链反应检测显示感染了HPV 11型。在5个月的时间里，通过冷冻疗法和电灼术对受累皮肤进行了全层切除。整个伤口敞开，通过二期愈合。经过3年的随访，患者未复发，功能恢复良好，美容效果也令人满意。这些微创技术可能比手术更安全、更具成本效益，全科医生在诊断中可发挥关键作用。
