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Buschke-Löwenstein Tumor: An Unusual Therapeutic Approach.

Raquel Gonçalves^1,2,3, Isabel Garrido^1,2,3, Rosa Coelho^1,2,3

¹Gastroenterology Department, São João Local Health Center, Porto, Portugal.

GE Portuguese Journal of Gastroenterology

|July 30, 2025

Summary

Giant condyloma acuminatum (Buschke-Löwenstein tumor) is a rare benign lesion. Neoadjuvant chemoradiotherapy effectively reduced a large perianal tumor in an immunosuppressed patient, offering significant clinical improvement.

Keywords:

Anogenital warts Buschke-Löwenstein tumor Giant condyloma acuminatum Human papillomavirus Immunosuppression

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Area of Science:

Dermatology
Oncology
Gastroenterology

Background:

Giant condyloma acuminatum (Buschke-Löwenstein tumor) is a rare, HPV-associated benign perianal neoplasm.
Established treatment guidelines are lacking due to its rarity.
Surgical intervention is the most commonly reported approach.

Purpose of the Study:

To report a case of giant condyloma acuminatum in an immunosuppressed patient.
To evaluate the efficacy of neoadjuvant chemoradiotherapy in managing this rare tumor.

Main Methods:

A 32-year-old immunosuppressed male with a large perianal tumor underwent biopsy, confirming condyloma acuminatum.
Initial treatment with imiquimod was ineffective.
Neoadjuvant chemoradiotherapy with capecitabine and mitomycin was administered.

Main Results:

The patient experienced significant lesion size reduction and clinical improvement after 5 months of chemoradiotherapy.
Complete resolution of proctological symptoms and need for analgesia was achieved.
No signs of malignancy were detected on histopathology.

Conclusions:

Neoadjuvant chemoradiotherapy can be an effective treatment option for giant condyloma acuminatum in select cases, particularly in immunosuppressed individuals.
Multidisciplinary management is crucial for optimizing treatment strategies.
Further research is needed to establish definitive treatment guidelines.