19 - Cadaveric Case Study: Large Condyloma with Discussion of Buschke-Lowenstein Tumor

Poster Board Number: 19
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Abstract Body : INTRODUCTION

Although anogenital condylomata are relatively common, in rare cases, infection by human papillomavirus (HPV) types 6 and 11 can lead to a giant condyloma acuminatum, also known as a Buschke-Lowenstein Tumor (BLT) – a locally destructive, frequently recurrent tumor that rarely metastasizes. Here we present a case of an exceptionally large condyloma, measuring 5.6 cm, on the dorsal penis of a cadaveric specimen, a probable precursor lesion to a BLT. Lesion presentation and extensive discussion of BLT is provided for educational purposes, an important topic given the increasing rarity of HPV lesions due to rising HPV vaccination rates.

MATERIALS & METHODS

A 65-year-old male cadaver whose cause of death was reported to be metastatic esophageal cancer was obtained for standard anatomical dissection through the KCU Gift Body Program. During the dissection, the cadaver was inspected in a systematic manner and lesions found were noted for their appearance and location. Afterwards, the lesions were photographed with a ruler for measurement by ImageJ software. Careful gross examination was also performed to ascertain the depth of invasion, if present.


RESULTS

On gross inspection, the cadaver was found to have a 5.6 cm x 2.8 cm, warty, cauliflower-like, papillomatous lesion covering almost the entirety of the dorsal penis which was compatible with condyloma formation. No definitive deep or peripheral invasion was identified on cut section. Aside from the penile lesion, there were two firm white mass lesions located in the upper esophagus and the stomach, likely secondary to the patient’s history of esophageal cancer.


CONCLUSION

Given the large size of the condylomatous lesion with lack of identifiable deep or peripheral invasion, the findings are most consistent with a probable precursor lesion to a full-fledged BLT. As HPV vaccination rates increase globally and prevalence of HPV-induced pathologies decrease, it will become critical to preserve such cases for learning purposes of increasingly rare entities like BLT. This case study and similar ones in the future can help the medical community build a foundational understanding of such entities.


SIGNIFICANCE/IMPLICATIONS

BLT, otherwise known as giant condyloma acuminatum, is a rare neoplasm typically associated with HPV-6 or HPV-11. This lesion has not been well studied in the medical literature through cadaveric studies. This cadaveric study can provide the medical community with greater knowledge on how to identify such tumors with discussion of the broader clinical implications.


FUNDING SOURCES

There are no financial conflicts of interest to disclose.