Reconstructive surgery in anal giant condyloma: Report of two cases.
BACKGROUND
Giant anal condyloma also called Buschke-Löwenstein tumor is a rare sexually transmitted disease involving anogenital region with potential malignant degeneration into invasive squamous carcinoma. Complete surgical excision is the treatment of choice and often wide wounds are necessary to reach clear margins and prevent recurrence.


METHODS
The authors present two cases treated with an S-plasty rotating and a bilateral house advancement flap respectively with good functional result.


CONCLUSIONS
Giant anal condyloma also called Buschke-Löwenstein tumor is a large exophytic, cauliflower-like mass that is characterized by local aggressive behavior. Immunosuppression favors rapid growth of the condylomas and increases the risk of their malignant transformation. In limited lesions primary excision can be safely performed leaving wounds open to granulate while in more extensive lesions flap or skin graft coverage is preferable to decrease the length of recovery and minimize risk of severe anal stricture. Abdominoperineal resection should be performed for more extensive lesions with deep invasion, malignant transformation or tumor recurrence.


CONCLUSIONS
Giant anal condyloma also called Buschke-Löwenstein is a rare pathology with mainly sporadic single center experience reported in literature. Surgical complete excision remains the best treatment although elevate should be eventual recurrence. No sufficient data are available to recommend any medical treatment such as interferon, radiotherapy or chemotherapy.
General Surgery Unit, San Giuseppe da Copertino Hospital - Asl Lecce, Copertino, LE, Italy. Electronic address: pieromingolla@libero.it.
Giuseppe Pietro
GP
Mingolla
Oscar
O
Potì
Giuseppe
G
Carbotta
Claudio
C
Marra
Gianluca
G
Borgia
Donato
D
De Giorgi
Buschke–Löwenstein tumor; Giant condyloma; House advancement flap; S-plasty rotating flap