Buschke-Löwenstein tumor with squamous cell carcinoma treated with chemo-radiation therapy and local surgical excision: report of three cases

World Journal of Surgical Oncology

Vincenzo Tombolini²  Daniela Musio²  Francesca De Felice²  Caterina Bangrazi²  Antonio Ciardi⁴  Paolo Gozzo¹  Cosima Maria Moschella¹  Gloria Bernardi¹  Gabriella D’Ettorre³  Alessio Impagnatiello¹  Marileda Indinnimeo¹ 

[1] Department of Surgery Pietro Valdoni - UOD of Surgery and Rehabilitation of the Pelvic Floor, Umberto I Policlinic of Rome, Sapienza University of Rome, Via Giovanni Maria Lancisi, Roma 2 00161, Italy;Department of Radiological, Oncological and Anatomo-Pathological Science - UOC of Radiotherapy, Viale Regina Elena, Roma 324 00161, Italy;Department of Public Health and Infectious Diseases - UOC of Infectious Diseases, Umberto I Policlinic of Rome, Sapienza University of Rome, Viale Regina Elena, Roma 324 00161, Italy;Department of Radiological, Oncological and Anatomic-Pathological Science - UOC of Pathological Anatomy and Histology, Umberto I Policlinic of Rome, Sapienza University of Rome, Via Giovanni Maria Lancisi, Roma 2 00161, Italy

关键词: Wide local excision;    Chemo-radiation therapy;    Giant condyloma acuminatum;    Human papillomavirus;    Buschke-Löwenstein tumor;   

Others  :  822032
DOI  :  10.1186/1477-7819-11-231

 received in 2013-02-19, accepted in 2013-09-02,  发布年份 2013

【 摘 要 】

Treatment of anorectal Buschke-Löwenstein tumor (BLT) with squamous cell carcinoma (SCC) transformation is not univocal given the rarity of the disease. BLT is characterized by its large size and tendency to infiltrate into underlying tissues. Malignant transformation can occur and it is important to identify the presence of neoplastic foci to decide the proper treatment. Our aim was to assess the effectiveness of neo-adjuvant chemo-radiation therapy (CRT) and local excision in order to avoid abdomino-perineal resection (APR). Three cases of anorectal BLT with SCC transformation are presented. All patients were HIV positive and treated with antiretroviral drugs. They underwent preoperative endoanal ultrasound, biopsies, total body tomography and anal brushing. Treatment consisted of neo-adjuvant chemo-radiation therapy (45 Gy to the pelvis plus a boost with 14.40 Gy to the primary tumor for a total of 59.40 Gy, and mitomycin-C in bolus on the first day, plus 5-fluorouracil by continuous infusion in the first and in the sixth week) and subsequent local surgical excision. During the follow-up, patients were subjected to the same preoperative diagnostic investigations and high resolution anoscopy. All patients showed a complete regression of the lesion after CRT and were treated by local surgical excision, thus avoiding permanent colostomy. In conclusion neo-adjuvant chemo-radiation therapy with local surgical excision could be considered an effective therapy in the treatment of anorectal BLT with SCC transformation to avoid APR.

【 授权许可】

   
2013 Indinnimeo et al.; licensee BioMed Central Ltd.

【 图 表 】

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