engleski

Invasive carcinoma developing in condylomata gigantea Buscke-Lowenstein

A 65-year-old male patient presented at the department of dermatology with a self-reported three to four year history of nodular changes on his penis. The diagnosis of Buschke-Lowenstein tumor, with focal malignant transformation to verrucous carcinoma, was put on the basis of clinical and histopathological features. Physical examination revealed verrucous, exophytic, partially ulcerated lesions all over the glans and the shaft of the penis with subsequent inflammation, together with smooth, nontender palpable lymph nodes in the inguinal region (measuring up to 0.5 cm in diameter). We excluded other lymph node involvement, immunosupression, as well as hepatitis, HIV (Human Immunodeficiency Virus) and other sexually transmitted infections. Histopathology showed atypical epithelial cells with acanthosis and hyperkeratosis, showing predominantly expansive growth with a focal invasion to sub epithelial tissue. There was an abundant peritumoral mononuclear infiltration. We performed a complete penectomy and lymph node resection. Lymph nodes showed no detectable tumor cells. HPV (Human Papilloma Virus) types 6 and 11 were detected and types 16, 18, 31, 33, 35, 52, and 58 were excluded by PCR (Polymerase Chain Reaction) analysis. Buschke-Lowenstein tumor arises on the external genitals and perianal region and is usually large, with the propensity to ulcerate, but without histomorphological criteria for malignancy. Malignant transformation of Buschke-Lowenstein tumor is usually associated with oncogenic HPV 16/18.However, the absence of these "high-risk" HPV types (as in our case) obviously does not exclude focally invasive squamous cell cercinoma.

invasive carcinoma; condylomata gigantea Buschke-Lowenstein

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