RESUMEN
BACKGROUND: Human papilloma virus (HPV) infection and condyloma acuminatum (CA) in the genital area often exist in extensive and multi-point fashion. Laser ablation combined with topical photodynamic therapy (PDT) is a feasible approach for genital CA but its effectiveness and limitations need to be evaluated. METHODS: This single-arm prospective study consisted of 100 newly diagnosed CA cases of both sexes. All patients underwent laser ablation and then three times aminolaevulinic acid-based photodynamic therapy (ALA-PDT). The outcomes were evaluated and analyzed 3 months after the treatment. RESULTS: A total of 98 patients completed the study. Except for 6 patients (4 males and 2 females) showed some residual lesions other 92 patients (93.8%) showed complete cure. However, there were 18 patients (10 males and 8 females) showed new lesions near the treated areas. Although the HPV types of 18 patients before and after treatment were not completely consistent, 94.4% percent of patients (17/18) had the same HPV type as the primary lesion, which suggested that these late-onset CA might have latent infection or subclinical infection in the early stage of the disease but the length of the incubation period was longer. CONCLUSION: Combination approach is effective in treating genital CA and preventing CA recurrence. But its limitations need to be recognized as the late-onset CA might occur near the treated area. The treatment plan needs to be optimized for multiple genital CA lesions.
Asunto(s)
Ácido Aminolevulínico/uso terapéutico , Condiloma Acuminado/terapia , Terapia por Láser/métodos , Infecciones por Papillomavirus/terapia , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Adulto , Terapia Combinada , Condiloma Acuminado/tratamiento farmacológico , Condiloma Acuminado/radioterapia , Femenino , Humanos , Láseres de Gas/uso terapéutico , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/tratamiento farmacológico , Infecciones por Papillomavirus/radioterapia , Estudios Prospectivos , Adulto JovenRESUMEN
Photodynamic therapy is mainly used in dermatology to treat skin tumors, precancerous lesions, and condyloma acuminatum. Due to its excellent tissue selectivity, easy operation and good cosmetic effect, it has been gradually applied to the treatment of various non-neoplastic skin diseases, such as verruca acuminata, acne, rosacea, chronic skin ulcer, fungal diseases, keloid, and so on. Here is the review on the advancement in photodynamic therapy for non-neoplastic skin diseases.
Asunto(s)
Fotoquimioterapia , Enfermedades de la Piel/radioterapia , Acné Vulgar/radioterapia , Condiloma Acuminado/radioterapia , Humanos , Investigación/tendenciasRESUMEN
We report the case of a patient with a large Buschke-Lowenstein tumour which had previously recurred following local excision. A preferred treatment modality for this rare variant of human papillomavirus has not been clearly defined. Treatment with chemo-radiotherapy in this case resulted in complete resolution of the disease without the need for further surgical intervention.
Asunto(s)
Neoplasias del Ano/terapia , Condiloma Acuminado/terapia , Papillomavirus Humano 11/aislamiento & purificación , Papillomavirus Humano 6/aislamiento & purificación , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos/uso terapéutico , Neoplasias del Ano/tratamiento farmacológico , Neoplasias del Ano/radioterapia , Neoplasias del Ano/virología , Cisplatino/uso terapéutico , Terapia Combinada , Condiloma Acuminado/tratamiento farmacológico , Condiloma Acuminado/radioterapia , Condiloma Acuminado/virología , Fluorouracilo/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoAsunto(s)
Condiloma Acuminado/radioterapia , Enfermedades de la Vulva/radioterapia , Adulto , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/radioterapia , Condiloma Acuminado/complicaciones , Femenino , Humanos , Lupus Eritematoso Sistémico/complicaciones , Enfermedades de la Vulva/complicaciones , Neoplasias de la Vulva/complicaciones , Neoplasias de la Vulva/radioterapiaRESUMEN
BACKGROUND: The Buschke-Löwenstein tumour (BLT) or giant condyloma acuminata is a rare disease which affects the anogenital region. Although histologically benign, it behaves in a malignant fashion, infiltrating the surrounding tissues. The morbidity and mortality from this tumour is high, as is the risk of recurrence following treatment. It lies on the continuum between the benign condylomata acuminata and squamous cell carcinoma. The human papillomavirus is implicated in its aetiology. Treatment is controversial, with topical chemotherapy, radiotherapy, immunotherapy and radical surgery all having been employed. Chemoradiation remains the mainstay of treatment for anal cancers but has not been routinely employed in the management of the BLT without squamous cell carcinoma transformation. METHODS: Two cases of extensive perineal BLT treated with chemoradiation and subsequent surgical excision are presented. RESULTS: The first patient had a good symptomatic response to the chemoradiation but unfortunately died of recurrent disease following surgery. The second patient had a macroscopically complete response to chemoradiation and remains well following abdominoperineal excision. CONCLUSION: Pre-operative chemoradiation has proved to be useful in management for histologically proven benign BLT
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Condiloma Acuminado/terapia , Terapia Neoadyuvante , Perineo/patología , Perineo/cirugía , Neoplasias de los Tejidos Blandos/terapia , Neoplasias Abdominales/secundario , Neoplasias Abdominales/terapia , Adulto , Neoplasias del Ano/secundario , Neoplasias del Ano/terapia , Carcinoma in Situ/patología , Carcinoma in Situ/terapia , Carcinoma de Células Escamosas/terapia , Quimioterapia Adyuvante , Cisplatino/administración & dosificación , Condiloma Acuminado/tratamiento farmacológico , Condiloma Acuminado/patología , Condiloma Acuminado/radioterapia , Condiloma Acuminado/cirugía , Resultado Fatal , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Radioterapia Adyuvante , Neoplasias del Recto/secundario , Neoplasias del Recto/terapia , Neoplasias de los Tejidos Blandos/tratamiento farmacológico , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/radioterapia , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
BACKGROUND AND OBJECTIVES: Genital warts represent benign epithelial proliferations induced by human papillomavirus. The goal of treatment is the clearance of visible warts. Different regimens are available. Flashlamp-pumped pulsed dye laser (FPDL) represents one of many treatment options for the management of viral warts (verrucae vulgares), its effectiveness being comparable with that of conventional therapies. We evaluated the effectivity of FPDL light for the treatment of genital warts. STUDY DESIGN/MATERIALS AND METHODS: A prospective study was performed to examine the efficacy of FPDL in untreated genital warts in which 22 patients were included. RESULTS: All patients showed complete remission after 1.59 (1-5) laser sessions and no scarring was observed. CONCLUSIONS: This study demonstrate that FPDL is a simple and safe, cost and time saving alternative treatment option for genital warts and should be listed in genital warts treatment guidelines.
Asunto(s)
Condiloma Acuminado/radioterapia , Terapia por Luz de Baja Intensidad , Enfermedades del Pene/radioterapia , Enfermedades de la Vulva/radioterapia , Adolescente , Adulto , Condiloma Acuminado/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Pene/patología , Enfermedades del Pene/virología , Estudios Prospectivos , Recurrencia , Resultado del Tratamiento , Enfermedades de la Vulva/patología , Enfermedades de la Vulva/virologíaRESUMEN
INTRODUCTION: The Buschke Löwenstein tumor (giant condyloma) in its perianal variant is an extremely rare disease caused by human papilloma virus. Although of histologically benign appearance, it infiltrates and destroys the surrounding tissue. There is a high risk of local recurrence and malignant transformation. The treatment of choice is wide surgical resection. CASE: A 56-year-old woman presented with perianal giant condyloma infiltrating the rectum and vagina. The extensive soft tissue defect resulting from wide resection was filled with a transpelvic myocutaneous rectus abdominis flap. Histology showed a squamous cell carcinoma arising in the Buschke Löwenstein tumor with clear resection margins. Therefore, the patient was irradiated locally after uneventful primary wound healing. CONCLUSION: A simultaneous reconstruction of a large pelvinoperineal soft tissue defect with the transpelvic myocutaneous rectus abdominis flap allows primary healing, accelerated rehabilitation, and safe adjuvant radiotherapy without risk of serious radiation damage to the small bowel by preventing it from protruding into the pelvic defect.
Asunto(s)
Neoplasias del Ano/cirugía , Carcinoma de Células Escamosas/cirugía , Condiloma Acuminado/cirugía , Neoplasias del Recto/cirugía , Colgajos Quirúrgicos , Canal Anal/patología , Canal Anal/cirugía , Neoplasias del Ano/diagnóstico , Neoplasias del Ano/patología , Neoplasias del Ano/radioterapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Transformación Celular Neoplásica/patología , Terapia Combinada , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Condiloma Acuminado/radioterapia , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Invasividad Neoplásica , Perineo/patología , Perineo/cirugía , Radioterapia Adyuvante , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Recto/patología , Recto/cirugíaRESUMEN
BACKGROUND: Treatment of anogenital warts is difficult in that the disease spectrum is wide. Moreover, varying degrees of improvement are obtained. OBJECTIVE: To study the treatment of persistent anogenital warts by pulsed dye laser. METHODS: Pulsed dye laser was used with the following settings: spot size 7 mm, pulse duration 1500 microsec, and fluence 7.5 J/cm2. Two different wavelengths were used: 585 and 595 nm. RESULTS: Lesions healed completely using both wavelengths after one treatment. CONCLUSION: Pulsed dye laser has been found to be safe, effective, satisfactory, and less traumatic compared to other options for treatment of perianal warts in children.
Asunto(s)
Enfermedades del Ano/radioterapia , Condiloma Acuminado/radioterapia , Terapia por Luz de Baja Intensidad , Preescolar , Humanos , MasculinoRESUMEN
The giant condyloma acuminatum of the perianal region is a tumor characterised by its large size with the propensity to infiltrate into deeper tissues, contrasting with a microscopically benign pattern. The evolution after malignant transformation of condyloma and lymph node invasion is rare. However it is exceptionally observed a lymph node invasion of microscopically benign condyloma acuminatum. The authors report a case of microscopically benign giant condyloma acuminatum of the perianal region associated with inguinal invasion, discovered in a 47 year-old man. Treatment consists in extensive surgery of the tumor and inguinal nodes, followed by a radiation therapy.
Asunto(s)
Neoplasias del Ano/patología , Carcinoma Verrugoso/patología , Condiloma Acuminado/patología , Neoplasias del Ano/radioterapia , Neoplasias del Ano/cirugía , Carcinoma Verrugoso/radioterapia , Carcinoma Verrugoso/cirugía , Condiloma Acuminado/radioterapia , Condiloma Acuminado/cirugía , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Radioterapia AdyuvanteRESUMEN
We report a case of a highly recurrent giant perianal condyloma, or Buschke-Lowenstein tumor, which was successfully treated by telecobalt therapy. We conclude that radiation therapy is an optional treatment modality for the management of giant perianal condylomata in selected cases.
Asunto(s)
Enfermedades del Ano/radioterapia , Condiloma Acuminado/radioterapia , Adulto , Enfermedades del Ano/patología , Biopsia , Condiloma Acuminado/patología , Humanos , Masculino , RecurrenciaRESUMEN
O condiloma acuminado é a doença sexualmente transmissível (DST) mais comum e sua incidência tem aumentado após o aparecimento da síndrome da imunideficiência adquirida. É causado pelo papilomavírus humano (HPV), podendo se apresentar como pequenas e múltiplas lesöes verrucóides, ou mais raramente como grandes, únicas e volumosas lesöes anais, sendo entäo denominado tumor de Buschke-Loewenstein, caso em que o tratamento é controverso com alto índice de recidiva. Os autores relatam a história de um paciente de 42 anos de idade, sexo masculino, branco, portador de condiloma perianal gigante recidivante que foi submetido a vários tratamentos (soluçäo de podofilina a 25 porcento, Bleomicina 1 porcento, operaçöes com ressecçäo e eletrocauterizaçäo e oxigenoterapia hiperbárica) sem sucesso. O paciente evoluiu com infecçäo perianal grave e presença de secreçäo local abundante, com dificuldade para evacuar, foi operado e feita ressecçäo da lesäo, sendo associada sigmoidostomia em alça. Como näo houve cura, e antes da indicaçäo da imputaçäo abdômino-perineal do reto iniciou-se tratamento com radioterapia. Foi administrado 4500 cGy (25 sessöes de 180 cGy cada) com equipamento de megavoltagem, culminando no desaparecimento da lesäo condilomatosa e consequente formaçäo de fibrose local. Näo ocorreu recidiva da lesäo anal, e também näo foi encontrado vírus na macrobiópsia realizada após 20 meses de seguimento ambulatorial. Este caso mostra que a radioterapia pode ser opçäo útil em casos excepcionais de lesöes condilomatosas extensas e recidivantes, antes de submeter o paciente a intervençäo radical com amputaçäo do reto e ânus
Asunto(s)
Humanos , Masculino , Adulto , Canal Anal/patología , Condiloma Acuminado/radioterapia , Neoplasias del Ano/radioterapia , Condiloma Acuminado/patología , Condiloma Acuminado/terapia , Recurrencia Local de NeoplasiaRESUMEN
The present study summarized results from 206 patients (120 females and 80 males) with diagnosis condylomata acuminata. The diagnostic and surveillance methods used in the present work were: clinical, colposcopic, histologies and microbiological examination. 114 from all patients--46.5% females, and 62.2% males were sexual partners. In 25 women (43.8%) from that group HPV-lesions were found. In 8 patients with cervical lesions CIN I-III was diagnosed. Our results confirmed the previously announced literary data about an enhanced risk for CIN development in women with HPV infection, whose sexual partners had clinical data of Condylomata acuminata. Our therapeutic protocol with Nd-YAG laser treatment in a determined scheme and number of applications according to the stage of the disease and pathological diagnosis was very successful, as compared to data from the literature.
Asunto(s)
Condiloma Acuminado/diagnóstico , Terapia por Láser , Enfermedades del Pene/diagnóstico , Lesiones Precancerosas/etiología , Parejas Sexuales , Displasia del Cuello del Útero/etiología , Neoplasias del Cuello Uterino/etiología , Enfermedades Vaginales/diagnóstico , Condiloma Acuminado/complicaciones , Condiloma Acuminado/radioterapia , Femenino , Humanos , Masculino , Enfermedades del Pene/radioterapia , Lesiones Precancerosas/radioterapia , Factores de Riesgo , Neoplasias del Cuello Uterino/radioterapia , Enfermedades Vaginales/complicaciones , Enfermedades Vaginales/radioterapia , Displasia del Cuello del Útero/radioterapiaRESUMEN
We present here the case of a patient with Buschke-Löwenstein tumor of the anus complicated by invasive squamous cell carcinoma metastatic to the inguinal and periaortic pelvic lymph nodes. Successful local palliation was achieved with 5-fluorouracil and mitomycin-C-based chemotherapy combined with radiation therapy, but systemic progression was unaffected.
Asunto(s)
Enfermedades del Ano/tratamiento farmacológico , Neoplasias del Ano/tratamiento farmacológico , Carcinoma de Células Escamosas/tratamiento farmacológico , Condiloma Acuminado/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica , Enfermedades del Ano/patología , Enfermedades del Ano/radioterapia , Neoplasias del Ano/patología , Neoplasias del Ano/radioterapia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/secundario , Terapia Combinada , Condiloma Acuminado/patología , Condiloma Acuminado/radioterapia , Fluorouracilo/administración & dosificación , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Mitomicina/administración & dosificación , Invasividad Neoplásica , Cuidados PaliativosRESUMEN
Giant condyloma acuminata, first described by Buschke and Löwenstein in 1925 as a penile lesion, is extremely rare in the anorectal region. The cauliflower-like tumor behaves clinically in a malignant fashion, although it shows no histomorphological criteria of malignancy. Up to the time of writing only 33 cases of anorectal origin, 42% with malignant transformation, have been published. The authors report 2 more cases of squamous-cell carcinoma in giant anorectal condylomata acuminata. Buschke-Löwenstein tumor is an intermediate entity between "ordinary" condyloma acuminata and squamous-cell carcinoma. Benign condyloma acuminata is caused by human papillomavirus 6 or 11. Carcinogenic cofactors promote the transition to giant, locally destructive condyloma acuminata and subsequent malignant transformation. Cure can only be achieved by early and radical excision. Formation of multiple fistulas and destruction of the sphincter may necessitate abdomino-perineal resection. Adjuvant radiation therapy should only be considered to render a tumor operable, as radiation may act as a cocarcinogenic effect and lead to a less differentiated and more aggressive cancer. The small number of cases reported and the variety of treatment regimens applied, however, do not allow the formulation of definitive therapeutic guidelines.
Asunto(s)
Neoplasias del Ano/cirugía , Carcinoma de Células Escamosas/cirugía , Condiloma Acuminado/cirugía , Neoplasias Primarias Secundarias/cirugía , Neoplasias del Recto/cirugía , Canal Anal/patología , Canal Anal/cirugía , Neoplasias del Ano/diagnóstico , Neoplasias del Ano/patología , Neoplasias del Ano/radioterapia , Biopsia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Transformación Celular Neoplásica/patología , Terapia Combinada , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Condiloma Acuminado/radioterapia , Sondas de ADN de HPV , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/radioterapia , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Recto/patología , Recto/cirugía , Reoperación , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Twenty cases of men treated with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for meatal and/or urethral condyloma over five years were reviewed. METHOD: All patients underwent Nd:YAG laser treatment of visible lesions as outpatients under general anesthesia using the visual urethrotome sheath and 0 degree lens. Follow-up urethroscopy was performed at three-month intervals. Cure of the gross disease was defined as negative findings on two sequential follow-up urethroscopies. RESULTS: All patients with gross condylomatous disease were verified to have type 6/11 human papillomavirus. Ninety-five percent had meatal condylomata of which 42 percent had concomitant distal urethral lesions. Thirty percent were cured of gross disease after one treatment, while 40 percent needed two, three, four, or five separate treatments before gross cure was obtained. Thirty percent had insufficient follow-up. Only 2 of the patients experiencing recurrence did so after negative finding on one follow-up urethroscopy. CONCLUSIONS: We believe attempts at cure of gross urethral condylomatous disease should be made because of its unsightliness and symptoms such as split stream and bleeding. Cure of gross disease with the Nd:YAG laser, as evidenced by our results, is possible. However, it may require several treatments. Follow-up urethroscopy is recommended in all patients because of the high incidence of recurrence and concomitant distal urethral involvement in those patients with meatal disease.
Asunto(s)
Condiloma Acuminado/radioterapia , Terapia por Láser , Enfermedades Uretrales/radioterapia , Estudios de Seguimiento , Humanos , MasculinoRESUMEN
The case of a 34-year-old female is reported, who has suffered from recurring condylomata acuminata of the anogenital region since she was 16. In the further course of the disease multiple Buschke-Loewenstein tumors developed, and finally an invasively growing, highly differentiated, keratinizing squamous cell carcinoma. The course of the disease was complicated by severe septicemia. In the framework of multimodal therapy, laser resection was the preferred method of surgical intervention. A systemic or local interferon treatment has only a prophylactic character in this stage of the disease.
Asunto(s)
Carcinoma de Células Escamosas/patología , Transformación Celular Neoplásica/patología , Condiloma Acuminado/patología , Neoplasias de los Genitales Femeninos/patología , Neoplasias del Recto/patología , Adulto , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirugía , Terapia Combinada , Condiloma Acuminado/radioterapia , Condiloma Acuminado/cirugía , Electrocoagulación , Femenino , Neoplasias de los Genitales Femeninos/radioterapia , Neoplasias de los Genitales Femeninos/cirugía , Humanos , Terapia por Láser , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/radioterapia , Recurrencia Local de Neoplasia/cirugía , Neoplasias del Recto/radioterapia , Neoplasias del Recto/cirugíaRESUMEN
Seventy-eight patients with condyloma acuminatum (51 with a lesion in the vulva, 11 in the uterine cervix, 1 in the vagina, 15 in multiple sites) have been treated by using three types of laser beam. The period to obtain epithelization after first treatment at the vulva, cervix and vagina was 4.4 +/- 1.8, 5.2 +/- 1.1 and 4.1 +/- 0.6 weeks (Mean +/- SD) respectively. The cure rates at the 10th week after first treatment and after first treatment during the follow-up periods between 10 weeks and 63 months were 78.2% (61/78) and 70.5% (55/78), respectively. The latter cure rates for each lesion were 70.3% in the vulva, 84.2% in the cervix and 72.7% in the vagina. In the recurrent group (62.5%), the incidence of partners with the disease was significantly higher (p less than 0.05) than that in the non-recurrent group (26.3%). No significant complication due to the therapy was found during or after treatment. This clinical study indicates that laser therapy is a useful method of treatment for condyloma acuminatum because of the short term healing with less complications and good cure rates.
Asunto(s)
Condiloma Acuminado/radioterapia , Terapia por Láser , Neoplasias del Cuello Uterino/radioterapia , Neoplasias Vaginales/radioterapia , Neoplasias de la Vulva/radioterapia , Condiloma Acuminado/patología , Femenino , Humanos , Neoplasias del Cuello Uterino/patología , Neoplasias Vaginales/patología , Neoplasias de la Vulva/patologíaRESUMEN
The authors describe the treatment of 37 patients with condyloma acuminatum by an electron beam with a preset energy. The therapy has been highly effective. No complications or relapses have been recorded over a follow-up of 1.5-4 years.
Asunto(s)
Neoplasias del Ano/radioterapia , Condiloma Acuminado/radioterapia , Neoplasias del Pene/radioterapia , Adolescente , Adulto , Electrones/uso terapéutico , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Aceleradores de Partículas , Dosificación RadioterapéuticaRESUMEN
Condyloma acuminatum are 'warty' lesions of viral aetiology. Four cases of squamous carcinoma arising within such condyloma are reported and discussed.