Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
Yaounde University Teaching Hospital, Yaounde, Cameroon.
J Med Case Rep. 2022 Mar 18;16(1):116. doi: 10.1186/s13256-022-03339-1.
Buschke-Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke-Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients.
We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ''butterfly wing'' structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke-Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection.
Buschke-Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.
Buschke-Löwenstein 肿瘤是一种巨大的尖锐湿疣感染，其特征为退化、侵袭和复发。它与人类乳头瘤病毒感染有关。它发生在生殖器和会阴区域周围，有时会导致大的芽状溃疡性病变。尽管人类免疫缺陷病毒感染在非洲很常见，但关于 Buschke-Löwenstein 肿瘤的诊断和治疗描述很少。必须在这些患者中系统地筛查其他性传播感染。
我们在此报告一例 21 岁的非洲裔男性患者，他出现会阴肿胀。体格检查显示有一个巨大的外生肿瘤，由粉红色的芽状植被组成，有锯齿状的嵴，呈“蝴蝶翼”结构，呈菜花状，顶端有离心性环状病变。肛门边缘也有多个尖锐湿疣病变。患者人类免疫缺陷病毒（CD4 计数为 119 个细胞/mm）和乙型肝炎感染检测呈阳性。实时聚合酶链反应显示人乳头瘤病毒 16 和其他高危型人乳头瘤病毒脱氧核糖核酸。肿块活检诊断为 Buschke-Löwenstein 肿瘤，患者接受了多学科干预（手术、鬼臼毒素应用和抗逆转录病毒治疗）。然而，由于机会性感染，中期病情发展导致死亡。
Buschke-Löwenstein 肿瘤是一种罕见的与人类免疫缺陷病毒感染相关的肿瘤。它在男性人类免疫缺陷病毒阳性患者中更为常见。需要筛查其他性传播感染。在大多数情况下，治疗是手术联合局部治疗。然而，复发很常见。
