Chu Q D, Vezeridis M P, Libbey N P, Wanebo H J
Division of Surgical Oncology, Roger Williams Medical Center, Brown University School of Medicine, Providence, Rhode Island 02908-4735.
Dis Colon Rectum. 1994 Sep;37(9):950-7. doi: 10.1007/BF02052606.
Giant condyloma acuminatum or Buschke-Loewenstein tumor of the anorectal and perianal regions is an uncommon entity that has not been extensively reviewed. We analyzed 42 known cases of giant condyloma acuminatum in the English literature and reviewed their behavior and management.
All reported cases of giant condyloma acuminatum in the English literature were selected. The relevant clinicopathologic features of this uncommon entity were examined and discussed.
These tumors are generally large with the propensity to ulcerate and infiltrate into deeper tissues. The hallmark of the disease is the high rate of recurrence (66 percent) and malignant transformation (56 percent). No distant metastases have been reported. The overall mortality was 20 percent, all occurring in patients with recurrences. Fifty percent of the patients who were initially treated with radical surgery developed recurrences. The average duration of disease was longer in patients with recurrences than in patients without recurrences (9.6 years vs. 2.8 years). The median number of recurrences was two (range, one to seven) recurrences, and the median time before first recurrence was ten months. Recurrences were treated by radical surgery in 17 patients and chemoradiotherapy +/- local excision in 5 patients. Follow-up information for the remaining five patients was not available. The cure rate in the radical surgery group was 61 percent compared with 25 percent in the chemoradiotherapy +/- local excision group.
Giant condyloma acuminatum of the anorectal and perianal regions is a highly aggressive tumor with the propensity for recurrences and malignant transformation, but without metastatic potential. A high rate of recurrence is seen in patients with long duration of the disease. Salvage of patients with recurrences can be achieved successfully with radical surgery.
肛管直肠和肛周区域的巨大尖锐湿疣或Buschke-Loewenstein肿瘤是一种罕见的疾病，尚未得到广泛的综述。我们分析了英文文献中42例已知的巨大尖锐湿疣病例，并回顾了其行为和治疗方法。
选择英文文献中所有报道的巨大尖锐湿疣病例。检查并讨论了这种罕见疾病的相关临床病理特征。
这些肿瘤通常较大，易于溃疡并浸润到更深的组织中。该疾病的标志是高复发率（66%）和恶变率（56%）。尚未有远处转移的报道。总死亡率为20%，均发生在复发患者中。最初接受根治性手术治疗的患者中有50%出现复发。复发患者的疾病平均持续时间比未复发患者更长（9.6年对2.8年）。复发的中位数次数为两次（范围为一至七次），首次复发前的中位数时间为十个月。17例患者通过根治性手术治疗复发，5例患者通过放化疗+/-局部切除治疗复发。其余5例患者的随访信息不可用。根治性手术组的治愈率为61%，而放化疗+/-局部切除组为25%。
肛管直肠和肛周区域的巨大尖锐湿疣是一种具有高侵袭性的肿瘤，有复发和恶变倾向，但无转移潜能。病程长的患者复发率高。复发患者可通过根治性手术成功挽救。
