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Buschke-Löwenstein肿瘤(BLT):根治性手术联合化疗成功治疗人乳头瘤病毒(HPV)相关的鳞状细胞癌

Buschke-Löwenstein Tumor (BLT): Successful Treatment of Human Papillomavirus (HPV)-Associated Squamous Cell Carcinoma With Radical Surgery and Chemotherapy.

作者信息

Baćo Stanko J, Mitric Milos, Mišić Jovica, Stakic Igor A, Đukanović Sonja

机构信息

General Surgery, Public Health Institution Hospital "Dr Mladen Stojanović", Prijedor, BIH.

General Surgery, Saint Luke the Apostle Hospital, Doboj, BIH.

出版信息

Cureus. 2024 Nov 1;16(11):e72828. doi: 10.7759/cureus.72828. eCollection 2024 Nov.

Abstract

The giant condyloma acuminatum, known as the Buschke-Löwenstein tumor (BLT), is an uncommon, slow-growing, cauliflower-like tumor located in the anogenital region. It has a high recurrence rate, is sexually transmitted, and is often linked with immunosuppression. This tumor is commonly associated with human papillomavirus (HPV) infection, making HPV one of the most prevalent sexually transmitted infections affecting the perineal and genital regions. Treatment options primarily involve a combination of surgical excision and adjuvant chemotherapy. In this report, we present the case of a 63-year-old heterosexual, HIV-negative female patient whose locally advanced disease severely impacted her quality of life due to multiple bilateral perianal fistulas and the development of squamous cell carcinoma. The patient also struggled with chronic anemia resulting from recurrent hemorrhages. She underwent a Miles procedure, consisting of an extralevator abdominoperineal excision with terminal colostomy. Following adjuvant chemotherapy, she achieved complete wound healing by secondary intention, with no complications or signs of wart recurrence. This report highlights that surgical resection, complemented by adjuvant therapy, can lead to excellent outcomes even in advanced cases with local progression, regional spread, and malignant transformation, without requiring additional reconstructive surgery or skin grafting, thus facilitating recovery.

摘要

巨大尖锐湿疣,即Buschke-Löwenstein肿瘤(BLT),是一种罕见的、生长缓慢的、位于肛门生殖器区域的菜花状肿瘤。它具有高复发率,通过性传播,且常与免疫抑制相关。这种肿瘤通常与人类乳头瘤病毒(HPV)感染有关,使得HPV成为影响会阴和生殖器区域的最常见性传播感染之一。治疗选择主要包括手术切除和辅助化疗。在本报告中,我们介绍了一名63岁的异性恋、HIV阴性女性患者的病例,其局部晚期疾病因多处双侧肛周瘘管和鳞状细胞癌的发生严重影响了她的生活质量。该患者还因反复出血而患有慢性贫血。她接受了Miles手术,包括经腹会阴扩大切除术及末端结肠造口术。辅助化疗后,她通过二期愈合实现了伤口完全愈合,无并发症或疣体复发迹象。本报告强调,即使在伴有局部进展、区域扩散和恶性转化的晚期病例中,手术切除辅以辅助治疗也能带来良好的效果,无需额外的重建手术或植皮,从而促进康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9099/11608924/83e7d69a8536/cureus-0016-00000072828-i01.jpg

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