Introduction:

Buschke-Löwenstein tumor is a rare tumor associated with human papillomavirus (HPV), most commonly HPV DNA types 6 and 11. This tumor can present an aggressive local invasive growth pattern with a high impact on quality of life. Early diagnosis and treatment of the condyloma acuminate can prevent this tumor development.

Case report:

We present a 49-year-old female, married, who has had a general and family medicine follow-up at a private practice for several years. In June 2016, a family physician was assigned to her family in public services, and she started to attend urgent care. In January 2018, she arranged an urgent appointment with her family physician where she showed a vulvar and peri-anal lesion. On examination, there were two large verrucous, malodorous growth masses: one measuring 9 × 6 cm in the vulvar region and 5 × 7.5 cm in the peri-anal region. When asked, the patient revealed that a small vulvar lesion appeared in 1992 and a peri-anal lesion in 2015, but they had a massive growth since 2017. After the explanation of the possible disease, the patient was referred to a gynecology consultation in the referral hospital. Towards the diagnosis of Buschke-Löwenstein tumor, she was submitted to a radical surgical excision with a protective colostomy, followed by plastic reconstruction of the anovulvar region. After the surgery, the patient had difficulty accepting her body image, with a great impact on her mental health.

Comment:

The follow-up at a women’s healthcare consultation, a specific consultation of general and family medicine specialty could permit an early identification of condyloma lesion and change the natural course of the disease, reducing physical and mental morbidity on the patient.

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