eP311 - An Abdominoperineal Resection for a Buschke-Lowenstein Tumor

Purpose/Background: Purpose: To discuss and describe a case for the treatment of Giant Anal Condyloma requiring an Abdominoperineal Resection with consideration of the patient psychosocial impact.

Introduction: A 43 year old man contracted HPV after a sexual assault while incarcerated and subsequently developed a Giant Anal Condyloma. Given his socioeconomic situation, he had a delay in diagnosis and care. At his presentation, his disease involved the rectal sphincter which was contributing to intermittent hemorrhage, obstructive symptoms and anal incontinence. Background: Human papilloma virus (HPV) is the most common sexually transmitted infection in the world. Giant Anal Condyloma, also known as a Buschke-Lowenstein Tumor, is a rare condition which develops in those who have contracted HPV. Though this condition is slow growing and benign, Giant Anal Condyloma is often treated similarly to a malignancy with neoadjuvant or adjuvant chemotherapies, CO2 laser vaporization, and radiation therapy because of the risk of malignant transformation. The rate of anal cancer in a Giant Anal Condyloma is between 50%-60% compared to a general condyloma acuminata at < 2%. The most definite therapy has been defined as wide excision with negative margins.Methods/Interventions: Descriptive case report of one patient.Results/Outcomes: A 43 year old man developed a Giant Anal Condyloma. Because of the size and location of his Giant Anal Condyloma he required an Abdominoperineal Resection and local tissue rearrangement to remove a 14cm x 9cm mass.Conclusion/

Discussion: Even though this is a benign condition, patients require aggressive surgical resection for treatment of Giant Anal Condyloma. Patients need extensive preoperative counseling about the morbidity of surgery and the discussion should be sensitive to the patient’s psychosocial situation.