Utility Of The Ultrasonic Scalpel In The Surgical Treatment Of The Buschke-Lowenstein Tumor (Giant Condyloma Acuminata)

摘要

Giant Condyloma Acuminata (Buschke and Lowenstein tumours) is a variation of condyloma caused by a sexually transmitted virus infection. Although it is a benign disease, it carries a risk of malignant transformation. Primary locations of giant condyloma are the perianal region and the external genitalia. We report an asymptomatic case of inguinal and perineal giant acuminata condyloma in a 46-year-old male of eight years evolution. After the surgical resection ultrasonic scalpel, the patient is free of recurrence twelve months later. Introduction Human papillomavirus (HPV) in one of the most common sexually transmitted disease (STD) and a significant cause of anogenital malignancies, premalignant lesions (cervical and anal intraepitelial neoplasia), and cutaneous disease. The most common manifestations of anogenital HPV-associated disease are genital warts (condylomata acuminata). These have the appearance of gray or flesh-colored sessile or pedunculated exophytic papules that may be found on the penis, vulva, cervix, anus, or perianal areas (1). Giant condyloma acuminta (GCA) or Buschke-Lowenstein tumors, are variants of warts, characterized by large cauliflower-like lesions on the penis or perianal area. Surgical extirpation constitutes the election treatment (2)We present an asymptomatic case of GCA, of long evolution, in a patient with negative HIV serology, treated with surgical resection, using the ultrasonic scalpel with extirpation of all the lesions in a unique session. The purpose of this article, making an evaluation of the utility of the ultrasonic scalpel, in the surgical treatment of this pathology. Clinical Case A 46 year-old male, without antecedents of interest, consults for presenting vegetating lesions in the anal region, of asymptomatic character and of eight years of evolution. He had no history of inmunodeficiency disease and took no medication. He denied having anoreceptive intercourse. Anal, perianal, inguinal and penis examination revealed giant condylomata (Fig. 1 and 2). Common analysis of laboratory: without alterations. Serology for lues, virus hepatitis A, B, C and HIV were negatives. Endoscopy didn't reveal extension of the illness in to the anorectal channel.