La tumeur de Buschke-Löwenstein

Buschke-Lowenstein’ tumor (BLT) or giant condylomata acuminata (GCA) is a pseudo-epithelial proliferation belonging to the verrucous carcinomas. It was first described in 1896. In 1925 Buschke and Lowenstein showed that it was characterized by disease-specific features. It is caused by human papilloma virus (HPV) a sexually transmitted infection mainly affecting the anogenital region. It can result in progressive degeneration and recur after treatment. Buschke-Lowenstein’s tumor is relatively rare and it is always preceded by condylomata acuminata. Its annual incidence appears to be 0.1% among the sexually active adult population. It can occur at any age after puberty but mainly between the 4(th)and 6(th)decades. The infection can affect both sexes but it most commonly occurs in males. Development, persistence, and recurrence rates of condylomas largely depend on the host’s immune status. Immunodepression, chronic inflammation, lack of hygiene and HIV infection appear to be risk factors for this disease. BLT is known to be caused by papillomavirus and, in particular, by HPV serotypes 6, 11. Prevention is essential and it should be based on the treatment of condylomata acuminata and the battle against sexually transmitted diseases. Early wide excision is mandatory. We here report the case of a 55-year old patient with a history of sexual vagrancy and recurrent urethritis, presenting with penile tumor progressing over the last 8 years. Clinical examination showed several fetid, painless, invasive, cauliflower papillomatous tumor lesions involving the root and ventral face of the penis. Lymph nodes were free. Serological tests for HIV, syphilis and hepatitis B and C were negative. Treatment was based on surgical excision with skin coverage using adjacent skin. Histological examination of the surgical specimen showed acute papillomatous hyperplasia of the epidermis and some koilocytes suggesting giant condyloma. At 2-year follow-up the patient didn’t show any recurrence.