Summary
Condylomas are a virus disease provoked by viruses from the HPV group, most often types are 6 and 11.
The prolonged growth of condylomas can lead to the cancerous transformation and/or enormous sizes of it. The gigantic figure of condylomas assumes the form of tumor or tumors of the crotch and is being called Buschke-Loewenstein tumor.
Currently, this type of change is considered to be precancerous stage. The clinical symptoms are result of the size and the locally malignant nature of the tumor. Most common symptoms are: bleeding, discomfort, recurrent abscesses or fistulas. In the case of the sphincter infiltration incontinance of gas or stool may occure. Risk factors are: immunodeficiency diseases (HIV, immunosupression) also diabetes, or risky behaviors. The diagnosis is based on clinical examination confirmed by histopathology, in cases of suspected infiltration of the sphincter is necessary to perform imaging (CT, TR ultrasound) and functional tests (anorectomanometry).
The treatment consists of excision of tumors in the protection of antiviral drugs.
In most cases, they require only the removal of skin lesions, sometimes operation must include other surrounding tissues, in such cases, stoma should be considered as the stage of elective treatment. Radiotherapy and chemotherapy treatment is necessary in case of confirmation of malignant transformation. No metastasis observed.
A particularly difficult problem in treatment is covering the skin defects arising after excision of multiple circular or around the anus tumors. One of the approaches is the “step by step” excision which considerably increases the time of healing.
In the article the authors present the operation of excision surrounding tumors without the stoma, with simultaneous supply skin losses by displacement of the anodermal flaps. Early results of this method are good, however, requires a long-term observation of a larger group of patients.