Giant condyloma acuminatum (GCA) is a rare cauliflower-like lesion, also known as Buschke-L ewenstein tumor (BLT). Although characterized by benign histological features, the local behavior of GCA is extremely aggressive, showing progressive infiltration of the surrounding structures leading to tissue destruction by compression. As the correlation between HPV and GCA development grew stronger, the majority of the Authors came to the conclusion that HPV can not only cause CA but, associated with particular risk factors, it can lead to much more serious conditions such as BLT. Since the treatment of GCA is still not yet standardized, a very accurate pre-operative analysis of the lesions is required to plan the most suitable treatment approach. Based on current knowledge, macroscopic evaluation of local tumor invasion and extensive radical resection appear to be the only valid therapeutic approach, due to its association with longterm survival and minimal recurrence. Looking forward for new techniques and new tissue sparing treatments, at the moment, GCA can be safely treated with radical excision without immediate tissue reconstruction; long-term complications, such as stricture and stenosis, can be prevented by adequate wound healing and by a particularly intense and long- term follow-up program. KEY WORDS: Anus, Giant condyloma acuminatum.

Il condiloma acuminato gigante (GCA) è una rara lesione simile a cavolfiore, nota anche come tumore di Buschke-Lewenstein (BLT). Sebbene sia caratterizzato da caratteristiche istologiche benigne, il comportamento locale del GCA può essre estremamente aggressivo, mostrando una progressiva infiltrazione delle strutture circostanti che portano alla distruzione del tessuto mediante compressione. Poiché la correlazione tra lo sviluppo di HPV e GCA è aumentata, la maggior parte degli Autori è giunta alla conclusione che l’HPV non solo può causare condilomatosi, ma, associato a particolari fattori di rischio, può portare a condizioni molto più gravi come BLT. Poiché il trattamento della GCA non è ancora standardizzato, è necessaria un’analisi preoperatoria molto accurata delle lesioni per pianificare l’approccio terapeutico più adatto. Sulla base delle attuali conoscenze, la valutazione macroscopica dell’invasione locale del tumore e l’estesa resezione radicale sembrano essere l’unico approccio terapeutico valido. In attesa di nuove tecniche e nuovi trattamenti di risparmio tissutale, al momento, la GCA dovrebbe essere trattata con un’escissione radicale senza una ricostruzione tissutale immediata; complicazioni a lungo termine, come la stenosi, possono essere prevenute con un’adeguata guarigione delle ferite e con un programma di follow-up particolarmente intenso e a lungo termine.

Burati, M., Chiarelli, M., Terragni, S., Tagliabue, F., Ripamonti, L., Maternini, M., et al. (2018). Treatment of giant condyloma acuminatum of the anus. State of the art. ANNALI ITALIANI DI CHIRURGIA, 89, 291-294.

Treatment of giant condyloma acuminatum of the anus. State of the art

Ripamonti, Lorenzo
Primo
;
Guttadauro, Angelo
Ultimo
2018

Abstract

Giant condyloma acuminatum (GCA) is a rare cauliflower-like lesion, also known as Buschke-L ewenstein tumor (BLT). Although characterized by benign histological features, the local behavior of GCA is extremely aggressive, showing progressive infiltration of the surrounding structures leading to tissue destruction by compression. As the correlation between HPV and GCA development grew stronger, the majority of the Authors came to the conclusion that HPV can not only cause CA but, associated with particular risk factors, it can lead to much more serious conditions such as BLT. Since the treatment of GCA is still not yet standardized, a very accurate pre-operative analysis of the lesions is required to plan the most suitable treatment approach. Based on current knowledge, macroscopic evaluation of local tumor invasion and extensive radical resection appear to be the only valid therapeutic approach, due to its association with longterm survival and minimal recurrence. Looking forward for new techniques and new tissue sparing treatments, at the moment, GCA can be safely treated with radical excision without immediate tissue reconstruction; long-term complications, such as stricture and stenosis, can be prevented by adequate wound healing and by a particularly intense and long- term follow-up program. KEY WORDS: Anus, Giant condyloma acuminatum.
Articolo in rivista - Articolo scientifico
Anus, Giant condyloma acuminatum;
English
2018
89
291
294
open
Burati, M., Chiarelli, M., Terragni, S., Tagliabue, F., Ripamonti, L., Maternini, M., et al. (2018). Treatment of giant condyloma acuminatum of the anus. State of the art. ANNALI ITALIANI DI CHIRURGIA, 89, 291-294.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/219641
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