Buschke-Löwenstein Tumor in HIV-Positive Patient, Surgically Treated by V-Y Advancement Flap, Case Report and Review of the Literature

Introduction: Buschke-Löwenstein tumor (BLT), known as giant condyloma acuminatum, is a sexually transmitted disease associated with human papillomavirus (HPV), mainly genotypes 6 and 11. The frequency of occurrence is rare and it is mainly located in the external genitalia and perineal region. Among the risk factors associated with this tumor are immunosuppression, alcoholism, smoking, the presence of genital infections, among others. Histologically, the distinctive feature of BLT is the lack of involvement of the basement membrane; however, it is said that this tumor presents mixed characteristics of squamous cell carcinoma and condyloma acuminatum. Clinically it manifests as a slow growing tumor, pain, itching and tends to present ulcerations, fistulas or bleeding as well as high risk of recurrence. Surgical resection with free margins and reconstruction is the gold standard of treatment, however there are multiple options and treatment must be individualized, taking into account the risk of recurrence and cancerous progression to squamous cell carcinoma. Case presentation: We present the case of a 24 year old male patient, HIV positive, with a giant condyloma acuminatum in the perianal region, affecting the anal canal and gluteal folds. Surgical resection of the tumor was performed with bilateral V-Y advancement flap reconstruction in both gluteal folds. The postoperative period was managed without serious complications and the patient showed a favorable evolution. Conclusion: Although surgical resection with reconstruction is the gold standard for the treatment of Buschke-Löwenstein tumor, treatment must be individualized due to the rarity of this pathology, especially in immunocompromised patients. In our case, the patient was treated by resection and V-Y advancement flap, achieving recovery without major complications.