Renal transplantlı bir hastada hızlı gelişen dev kondiloma akuminatum: olgu sunumu

Dev kondiloma aküminatum genellikle human papillomavirus (HPV) subtip 6 veya 11 enfeksiyonları ile görülmekte olup, anogenital bölgede karnabahar benzeri agresif büyüyen kitle ile karakterizedir. Kişinin bağışıklığı hastalığın ana risk faktörlerinden biri olduğundan, lezyonlar bağışıklığı baskılanmış hastalarda daha sık görülür. Bu yazıda, cinsel olarak inaktif bir renal transplant alıcısında görülen dev bir vulvar kondiloma aküminatum olgusu sunulmuştur. Dört yıl önce renal transplantasyon geçiren ve o zamandan beri immünosupresyon tedavisi alan 25 yaşındaki hasta, vulvar bölgede hızla büyüdüğünü fark ettiği bir kitle nedeni ile başvurmuştur. Kondiloma aküminatum lehine değerlendirilen ve geniş cerrahi eksizyon yapılan hastanın takiplerinde nüks görülmemiştir. Cerrahi eksizyon, hızlı büyüyen vulvar kondilomlu immün sistemi baskılanmış hastalarda kesin tedavi yöntemi olarak görülmektedir.

Anahtar Kelimeler:

Kondiloma aküminatum, Human papillomavirus (HPV), immünosupresyon

Giant condyloma acuminatum in a female renal transplant recipient with rapid development: a case report

Giant condyloma acuminatum (GCA) usually occurs on a set of human papillomavirus (HPV) subtype 6 or 11 infections and is characterized by cauliflower-like aggressive growing mass over the anogenital region. Lesions are more often observed in immunocompromised patients since host immunity is one of the main risk factors of the disease. We report a case of a GCA in a sexually inactive renal transplant recipient. A 25-year-old patient who had renal transplantation four years prior and has been receiving immunosuppression therapy since presented with the rapid growth of a vulvar mass noticed. A wide surgical excision was performed and the patient had no recurrence at her follow-ups. Surgical excision is the definitive treatment in immunocompromised patients with the rapid growth of vulvar condylomas.

Keywords:

condyloma acuminatum, HPV, immunosuppression,

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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.
Elfgren K, Kalantari M, Moberger B, Hagmar B, Dillner J. A population-based five-year follow-up study of cervical human papillomavirus infection. Am J Obstet Gynecol. 2000;183:561-7.
Sanclemente G, Herrera S, Tyring S, Rady P, Zuleta J, Correa L et al. Human papillomavirus (HPV) viral load and HPV type in the clinical outcome of HIV-positive patients treated with imiquimod for anogenital warts and anal intraepithelial neoplasia. J Eur Acad Dermatol Venereol.. 2007;21:1054-60.
Gaspari AA, Zalka AD, Payne D, Menegus M, Bunce LA, Abboud CN et al. Successful treatment of a generalized human papillomavirus infection with granulocyte-macrophage colony-stimulating factor and interferon gamma immunotherapy in a patient with a primary immunodeficiency and cyclic neutropenia. Arch Dermatol. 1997;133:491-6.
Renzi A, Giordano P, Renzi G, Landolfi V, Del Genio A, Weiss EG. Buschke-Lowenstein tumor successful treatment by surgical excision alone: a case report. Surg Innov. 2006;13:69-72.
Lilungulu A, Mpondo BCT, Mlwati A, Matovelo D, Kihunrwa A, Gumodoka B. Giant condyloma acuminatum of vulva in an HIV-infected woman. Case Rep Infect Dis. 2017;2017:5161783.
Tripoli M, Cordova A, Maggì F, Moschella F. Giant condylomata (Buschke-Löwenstein tumours): our case load in surgical treatment and review of the current therapies. Eur Rev Med Pharmacol Sci. 2012;16:747-51.
Bhageerathy PS, Cecilia M, Sebastian A, Raghavendran A, Abraham P, Thomas A et al. Human papilloma virus-16 causing giant condyloma acuminata. J Surg Case Rep. 2014:1:126.
Costa-Silva M, Fernandes I, Rodrigues AG, Lisboa C. Anogenital warts in pediatric population. An Bras Dermatol. 2017;92:675-81.
Pennycook KB, McCready TA. Condyloma acuminata. In Stat Pearls. Treasure Island (FL), StatPearls Publishing, 2022.
Bruns, T. N. C, Lauvetz, R. J, Kerr, E. S, & Ross, G. Buschke-Lowenstein giant condylomas: pitfalls in management. Urology. 1975;5,773-6.
Rachman A, Hasan N. Giant condyloma acuminata in Indonesian females with SLE under immunosuppressant and steroid therapy. Case Rep Immunol. 2016;2016:4710979.
Schneider V, Kay S, Lee HM. Immunosuppression as a high-risk factor in the development of condyloma acuminatum and squamous neoplasia of the cervix. Acta Cytologica. 1983;27:220-4.
Massad LS, Xie X, Darragh T, Minkoff H, Levine AM, Watts DH et al.Women's interagency HIV study collaborative study group. Genital warts and vulvar intraepithelial neoplasia: natural history and effects of treatment and human immunodeficiency virus infection. Obstet Gynecol. 2011;118:831-9.
Kavanaugh BE, Odem-Davis K, Jaoko W, Estambale B, Kiarie JN, Masese LN et al.Prevalence and correlates of genital warts in Kenyan female sex workers. Sex Transm Dis. 2012;39:902-5.
Tan XJ, Wu M, Lang JH. Giant condyloma acuminatum of the vulva. Int J Infect Dis. 2010;14:455-6.
Atkinson AL, Pursell N, Sisay A. The giant condyloma (Buschke-Löwenstein tumor) in the immunocompromised patient. Case Rep Obstet Gynecol. 2014;2014:793534.
Zekan J, Petrovic D, El-Safadi S, Banovic M, Hulina D, Hrgovic Z. A surgical approach to giant condyloma (Buschke-Löwenstein tumour) with underlying superficial vulvar carcinoma: A case report. Oncol Lett. 2013;5:541-3.