Buschke-Löwenstein Tumor: Ano-Perineal Location (About 4 Cases)

Buschke-Löwenstein tumor belongs to the group of verrucous carcinomas, a relatively rare condition and always precedes condyloma acuminata. This tumor is more common in men and immunocompromised people, it develops in the genital area, the perineum and the anus, creating a large budding lesion. The aim of our work is to analyze the epidemiological, clinical, paraclinical and therapeutic data of these tumors based on our 4 observations collected over 2 years and a review of the literature. The average age was 47.5 years with a male predominance. Sex ratio 3. The three men had spent time in a prison environment. All patients had had at least one anal coitus. Clinical signs are represented by anal swelling, rectal bleeding, moist anus and signs of anemia. Proctological examination revealed an ulcerative-budding cauliflower appearance in all patients. Immunodeficiency virus serology (HIV) was positive in 3 patients. The biopsy revealed a Buschke-Löwenstein tumor without signs of transformation in 3 patients with one case of squamous cell carcinoma. An abdominopelvic CT scan was performed in all patients revealing no signs of sphincter infiltration or other neighboring organs. The treatment consisted of a wide excision associated with analplasty in all patients. Eight months later, we noted a recurrence in one patient, but very minimal, who was treated by electrocautery. Surgical management of Buschke-Löwenstein tumor must be carried out by an experienced surgeon.