Rapid progression of an anal Buschke-Lowenstein tumour into a metastasising squamous cell carcinoma in an HIV-infected patient.
BACKGROUND
Buschke-Löwenstein tumour (BLT) of the anogenitalia is a locally invasive, destructively growing verrucous carcinoma that does not metastasise. Histologically BLT resembles benign condylomata acuminata. Nevertheless, the tumour grows relentlessly and may rarely progress into squamous cell cancer (SCC).


RESULTS
A human immunodeficiency virus (HIV)-infected immunosuppressed patient developed (peri)anal warts accompanied by recurrent abscesses and fistulae. Histology revealed condylomata acuminata, and low-risk genital human papillomavirus (HPV) type 11b was detected. Six months later, the tumour had progressed into an ulcerated SCC that destroyed the rectum and perineum, with metastases to the inguinal lymph nodes. Whereas highly active antiretroviral therapy (HAART) effectively suppressed HIV replication, radiochemotherapy plus anti-EGFR antibody did not halt tumour progression, and the patient died from tumour-cachexia.


CONCLUSIONS
As far as is known, this is the first report demonstrating rapid progression of a BLT into a metastasising SCC in an HIV-infected patient.
Handisurya
A
A
Laboratory of Viral Oncology (LVO), Division of Immunology, Allergy and Infectious Diseases(DIAID), Department of Dermatology, Medical University Vienna, Vienna, Austria.
Rieger
A
A
Bago-Horvath
Z
Z
Schellenbacher
C
C
Bankier
A
A
Salat
A
A
Stingl
G
G
Kirnbauer
R
R
D001003:Anal Canal / Q000473:pathology / Q000821:virology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000473:pathology* / Q000628:therapy; D002100:Cachexia / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000628:therapy; D017809:Fatal Outcome; D006119:Groin; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness
D019380:Anti-HIV Agents