Perianal reconstruction with V-Y flap due to Büschke-Löwenstein tumor
Keywords:
HIV infections, condyloma acuminata, reconstructive surgical procedures.Abstract
Introduction: The giant condyloma acuminata is a rare disease that manifests itself in 0.1% of people with an active sexual life, its treatment is variable, surgery being the most radical and definitive, although recurrence is not negligible. In case of large defects in the perianal region after resection, flap rotation is useful to cover the defect.Objectives: To expose the reconstructive surgical treatment performed on a patient with perianal Büschke-Löwenstein tumor.
Clinical case: A 47-year-old African American male patient with a history of HIV infection diagnosed 8 months prior to the current consultation, in treatment with antiretrovirals. Who came to the clinic with an anal lesion in the shape of a cauliflower, which occupies a diameter of approximately 10 cm, a surgical procedure was performed as a definitive treatment through excision and anoplasty with a V-Y flap, and the vegetative lesion on the edge was excised, internal of the right gluteus whose area was part of the V-Y flap.
Conclusions: Reconstructive techniques in the perianal region must be individualized in each case, depending on the type of defect, its topography, and local conditions, and although there may be a preference for one over others, the scientific literature does not provide sufficient evidence in this regard. The reconstructive technique performed on the patient showed that even with high rates of recurrence and complications, it was effective for the patient despite having comorbidities that could influence a torpid evolution.
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References
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9. Sentovich SM, Falk PM, Christensen MA, Thorson AG, Blatchford GJ, Pitsch RM. Operative results of House advancement anoplasty. Br J Surg. 1996; 83(9):1242-44. DOI: 10.1046/j.1365-2168.1996.02266.x
10. Kokosis G, Phillips BT, Soo J, Poveromo L, Erdmann D, Mantyh CR, et al. Modified V-Y Fasciocutaneous Flap Reconstruction After Abdominoperineal Resection in Irradiated Patients Prevents Wound Dehiscence and Associated Complications. Annals of Plastic Surgery. 2019; 82(2):218-23. DOI: 10.1097/sap.0000000000001672
11. Ibañez N, Abrisqueta J, Luján J, Hernández Q, Parrilla P. El colgajo V-Y como método de reparación de defectos perianales extensos. Cirugía Española. 2016; 94(9): 525-30. DOI: 10.1016/j.ciresp.2016.06.006
12. Hassan I, Horgan AF, Nivatvongs S. V-Y island flaps for repair of large perianal defects. The American Journal of Surgery. 2001; 181(4):363-5. DOI: 10.1016/s0002-9610(01)00578
13. McCutcheon T. Anal Condyloma Acuminatum. Gastroenterology Nursing. 2009; 32(5): 342-9. DOI: 10.1097/sga.0b013e3181b85d4e
14. Silvera RJ, Smith CK, Swedish KA, Goldstone SE. Anal condyloma treatment and recurrence in HIV-negative men who have sex with men. Dis Colon Rectum. 2014; 57(6):752-61. DOI: 10.1097/DCR.0000000000000080
15. Charúa GL, Trabanino Pacas MA, Osorio Hernández RM, Navarrete Cruces T, Avendaño Espinosa O. Recurrencia temprana del condiloma anal acuminado posterior a condilomectomía. Revista Médica del Hospital General de México. 2004; 67(3):140-5. [acceso: 20/07/2022]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15765975/
2. Davis KG, Barton JS, Orangio G, Bivin W, Krane S. Buschke-Lowenstein Tumors: A Review and Proposed Classification System. Sex Transm Dis. 2021; 48(12):e263-e268. DOI: 10.1097/OLQ.0000000000001437
3. Boda D, Cutoiu A, Bratu D, Bejinariu N, Crutescu R. Buschke-Löwenstein tumors: A series of 7 case reports. Exp Ther Med. 2022; 23(6):393. DOI: 10.3892/etm.2022.11320
4. Nieves Condoy JF, Acuña Pinzón CL, Chavarría Chavira JL, Hinojosa Ugarte D, Zúñiga Vázquez LA. Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage. Infect Dis Obstet Gynecol. 2021; 2021:9919446. DOI: 10.1155/2021/9919446
5. Rivera Alvarez F, Kwon B, Ganti L. Buske-Lowenstein Tumor: A Rare Cause of Genital Warts. Cureus. 2022; 14(3):e23477. DOI: 10.7759/cureus.23477
6. Manlubatan SIT, Onglao MAS, Tampo MMT, Lopez MPJ. Outcomes of surgical management of buschke-lowenstein tumor in a Philippine tertiary hospital. Ann Coloproctol. 2022; 38(1):82-87. DOI: 10.3393/ac.2020.00731.0104
7. Houvenaeghel G, Ghouti L, Moutardier V, Buttarelli M, Lelong B, Delpero JR. Rectus abdominis myocutaneous flap in radical oncopelvic surgery: a safe and useful procedure. Eur J Surg Oncol. 2005; 31(10):1185-90. DOI: 10.1016/j.ejso.2005.07.004
8. Orkin BA. Perineal reconstruction with local flaps: technique and results. Tech Coloproctol. 2013; 17(6):663-70. DOI: 10.1007/s10151-013-0978-y
9. Sentovich SM, Falk PM, Christensen MA, Thorson AG, Blatchford GJ, Pitsch RM. Operative results of House advancement anoplasty. Br J Surg. 1996; 83(9):1242-44. DOI: 10.1046/j.1365-2168.1996.02266.x
10. Kokosis G, Phillips BT, Soo J, Poveromo L, Erdmann D, Mantyh CR, et al. Modified V-Y Fasciocutaneous Flap Reconstruction After Abdominoperineal Resection in Irradiated Patients Prevents Wound Dehiscence and Associated Complications. Annals of Plastic Surgery. 2019; 82(2):218-23. DOI: 10.1097/sap.0000000000001672
11. Ibañez N, Abrisqueta J, Luján J, Hernández Q, Parrilla P. El colgajo V-Y como método de reparación de defectos perianales extensos. Cirugía Española. 2016; 94(9): 525-30. DOI: 10.1016/j.ciresp.2016.06.006
12. Hassan I, Horgan AF, Nivatvongs S. V-Y island flaps for repair of large perianal defects. The American Journal of Surgery. 2001; 181(4):363-5. DOI: 10.1016/s0002-9610(01)00578
13. McCutcheon T. Anal Condyloma Acuminatum. Gastroenterology Nursing. 2009; 32(5): 342-9. DOI: 10.1097/sga.0b013e3181b85d4e
14. Silvera RJ, Smith CK, Swedish KA, Goldstone SE. Anal condyloma treatment and recurrence in HIV-negative men who have sex with men. Dis Colon Rectum. 2014; 57(6):752-61. DOI: 10.1097/DCR.0000000000000080
15. Charúa GL, Trabanino Pacas MA, Osorio Hernández RM, Navarrete Cruces T, Avendaño Espinosa O. Recurrencia temprana del condiloma anal acuminado posterior a condilomectomía. Revista Médica del Hospital General de México. 2004; 67(3):140-5. [acceso: 20/07/2022]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15765975/
Published
2023-01-01
How to Cite
1.
Hernández Álvarez M, Oliu Lambert H, de la Cruz de Oliu NA, Cabrera Martínez JE. Perianal reconstruction with V-Y flap due to Büschke-Löwenstein tumor. Rev Cubana Med Milit [Internet]. 2023 Jan. 1 [cited 2025 Mar. 13];52(1):e02302218. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2218
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