Difficulties of diagnosis and treatment in giant condyloma of Buschke and Löwenstein (GCBL) which led to fatal outcome in a woman

Background: GCBL is a slowly growing, locally destructive verrucous lesion typically appearing in the anogenital region. It is characterized by a large size and tendency to infiltrate the deeper tissues despite its histologically benign appearance. It is regarded as an intermediate lesion between condyloma acuminatum and verrucous carcinoma, but some authors classify these tumors as a regional variant of the verrucous carcinoma.

Case report: The authors present a 48-year-old woman who had been treated with condylomatous warts. After unsuccessful local administration of podophyllum, recurrent lesions have been removed surgically. After a year of uncontrolled period a locally destructive perianal lesion appeared and CT revealed an extension toward the pelvic organs. There was no evidence of distant metastases. Extended surgical exstirpation of abdominoperineal region was offered but the patient refused this operation. Some month later a laparoscopic assisted loop colostomy was performed because of fecal incontinency accompanied by subileus. The patient died three years after the first topical treatment due to tumorous cachexia. This report focused on the pathological diagnostic possibilities to avoid misdiagnosis and the benefit and technique of laparoscopic loop colostomy in palliative colorectal surgery and also offer a short review of the current literature in this subject.