Articles

Buschke-Löwenstein tumour (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight

Paulus Mario Christopher , Hartono Kosim, Ratna Sari Wijaya, Silvi Suhardi, Linda Julianti Wijayadi

Paulus Mario Christopher
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Email: paulusmarioc@gmail.com

Hartono Kosim
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia

Ratna Sari Wijaya
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia

Silvi Suhardi
Department of Dermatovenereology, Universitas Tarumanagara, Indonesia

Linda Julianti Wijayadi
Department of Dermatovenereology, Universitas Tarumanagara, Indonesia
Online First: June 01, 2020 | Cite this Article
Christopher, P., Kosim, H., Wijaya, R., Suhardi, S., Wijayadi, L. 2020. Buschke-Löwenstein tumour (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight. Bali Dermatology and Venereology Journal 3(1). DOI:10.15562/bdv.v%vi%i.27


Buschke Löwenstein tumor (BLT)/giant condyloma acuminatum is a rare variant of sexually transmitted infection caused by human papillomavirus (HPV) type 6 and 11. HPV has its viral factors that exist to avoid immune surveillance and control through 1) infecting only the basal layer of the epithelium, 2) downregulation of host immunity, 3) suppression of proinflammatory proteins essential for viral clearance. The incidence of BLT/GCA is estimated to be 0.1% in the general population, with males having 2.7 times increased risk than females. BLT/GCA is characterized by verrucous tumor or palpable cauliflower-likemass, exophytic growth, flesh-colored, and uneven surface. The definitive diagnosis of BLT/GCA is typical morphology along with histopathological examination, and/or viral serotyping. Treatment of BLT/GCA requires a multidisciplinary approach, determined based on age, the extent of the lesion, organ involvement, and organ location.

References

Martίn JM, Molina I, Monteagudo C, Marti N, Lόpez V, Jorda E. Buschke-Lowenstein tumor. J Dermatol Case Rep. 2008; 4: 60-2.

Safi F, Bekdache O, Al-Salam S, Alashari M, Mazen T, El-Salhat H. Management of peri-anal giant condyloma acuminatum – A case report and literature review. Asian J Surg. 2013; 36(1): 43-52.

Yanofsky VR, Patel RV, Goldenberg G. Genital warts a comprehensive review. J Clin Aesthet Dermatol. 2012; 5(6): 25-36.

Manga MM, Fowotade A, Yahaya M. Human papillomavirus (HPV) infection in males: A need for more awareness. In: Current perspectives in human papillomavirus. InTechOpen; 2019. p. 4.

Shew ML, Fortenberry JD. HPV infection in adolescents: Natural history, complications, and indicators for viral typing. Semin Pediatr Infect Dis. 2005; 16(3): 168-74.

Saxena SK, Kumar S, Goel MM, Kaur A, Bhatt MLB. Recent advances in human papillomavirus infection and management. In: Current perspectives in human papillomavirus. InTechOpen; 2019. p. 2.

Indriatmi W. Epidemiologi infeksi menular seksual. Presented at: Simposium Sexually Transmitted Infection Arising Concern; 2012 Sep 15-16; Semarang, Indonesia.

Martínez-Cumplido R, Gonzalez-Bosquet E. Giant cervical condyloma during pregnancy: A case report. Int J Women’s Health Reprod. Sci. 2016; 4(2): 81-3.

Steinbach A, Riemer AB. Immune evasion mechanisms of human papillomavirus: An update. Int J Cancer. 2018; 142: 224-29.

Niazy F, Rostami K, Motabar AR. Giant condyloma acuminatum of vulva frustrating treatment challenge. World J Plast Surg. 2015; 4(2): 159-62.

Türkdogan P, Bastürk O, Demir MA, Zeytinoglu A, Seyhan A. Giant condyloma acuminatum – Two cases with microinvasive foci in one. Aegean Pathology Journal. 2004; 1: 62-5.

Doorbar J, Egawa N, Griffin H, Kranjec C, Murakami I. Human papillomavirus molecular biology and disease association. Rev Med Virol. 2016; 25: 2-23.

Miller DL, Puricelli MD, Stack MS. Virology and molecular pathogenesis of HPV (human papillomavirus) – Associated oropharyngeal squamous cell carcinoma. Biochem J. 2012; 443 (2): 339-53.

Georgescu SR, Mitran CI, Mitran MI, et al. New insights in the pathogenesis of HPV infection and associated carcinogenic processes: The role of chronic inflammation and oxidative stress. J Immunol Res. 2018; 2018: 1-10.

Graham S V. The human papillomavirus replication cycle, and its links to cancer progression: A comprehensive review. Clin Sci. 2017; 131(17): 2201–21.

Abbas AK, Lichtman AH. Basic immunology functions and disorders of the immune system. 3rd ed. Philadelphia: Elsevier; 2011.

Garza L. Developmental biology of the skin. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, et al, editors. Fitzpatrick’s dermatology. New York: Mc Graw Hill Education; 2019. p. 49.

Nunes RAL, Morale MG, Silva GAF, Villa LL, Termini L. Innate immunity and HPV: friends or foes. Clinics. 2008; 73(1): e549s.

Sasagawa T, Takagi H, Makinoda S. Immune responses against human papillomavirus (HPV) infection and evasion of host defense in cervical cancer. J Infect Chemother. 2012; 18: 807-15.

Einstein MH, Schiller JT, Viscidi RP, et al. Clinician’s guide to human papillomavirus immunology: knowns and unknowns. Lancet Infect Dis. 2009; 9(6): 347–56.

Wakabayashi R, Nakahama Y, Nguyen V, Espinoza JL. The host-microbe interplay in human papillomavirus-induced carcinogenesis. Microorganisms. 2009; 7(199): 1-22.

Jimenez-Flores R, Mendez-Cruz R, Ojeda-Ortiz J, Muñoz-Molina R, Balderas-Carrillo O, De La Luz Diaz-Soberanes M, et al. High-risk human papilloma virus infection decreases the frequency of dendritic Langerhans’ cells in the human female genital tract. Immunology. 2006;117(2):220–8.

Camargos DDS, Tafuri A, Fernandes PA, Caliari MV, Dutra WO, Vago AR. Langerhans cells ascertaining in cervical tissues obtained from women with cervical intraepithelial neoplasia. Reprod Syst Sex Discord. 2017; 6(1): 1-5.

Sutlu T, Alici E. Natural killer cell-based immunotherapy in cancer: Current insights and future prospects. J Intern Med. 2009;266(2):154–81.

Utami TW. NK-Cell Count and its Function in Producing Interferon Gamma Associated with the Cervical Cancer Natural History. Glob J Reprod Med. 2018;4(2):1–6.

Zhao H, Zhang J-X. Natural killer cells: the first defense against human papilloma virus early infection. J Public Heal Emerg. 2017; 1(5): 5–5.

Deligeoroglou E, Giannouli A, Athanasopoulos N, Karountzos V, Vatopoulou A, Dimopoulos K, et al. HPV infection: Immunological aspects and their utility in future therapy. Infect Dis Obstet Gynecol. 2013; 2013: 1-9.

Chen XJ, Han LF, Wu XG, Wei WF, Wu LF, Yi HY, et al. Clinical significance of CD163+ and CD68+ tumor-associated macrophages in high-risk HPV-related cervical cancer. J Cancer. 2017; 8(18): 3868–75.

Zhou C, Tuong ZK, Frazer IH. Papillomavirus Immune Evasion Strategies Target the Infected Cell and the Local Immune System. Front Oncol. 2019; 9: 1-18.

Barros MR, de Melo CML, Barros MLCMGR, de Cássia de Lima R, de Freitas AC, Venuti A. Activities of stromal and immune cells in HPV-related cancers. J Exp Clin Cancer Res. 2018; 37(137): 1-18.

Terabe M, Berzofsky JA. Tissue-specific roles of NKT cells in tumor immunity. Front Immunol. 2018; 9: 1–11.

Roberson FC, Berzofsky JA, Terabe M. NKT cell networks in the regulation of tumor immunity. Front Immunol. 2014; 5: 1-13.

Stanley MA, Sterling JC. Host responses to infection with human papillomavirus. Curr Probl Dermatology. 2014; 45: 58–74.

Gonçalves MAG, Donadi EA. Immune cellular response to HPV: current concepts. Braz J Infect Dis. 2004; 8(1): 1–9.

Bonin CM, Padovani CTJ, da Costa IP, et al. Detection of regulatory T cell phenotypic markers and cytokines in patients with human papillomavirus infection. J Med Virol. 2018; 91(2): 317-25.

Ao C, Zeng K. The role of regulatory T cells in pathogenesis and therapy of human papillomavirus-related diseases, especially in cancer. Infect Genet Evol. 2018; 65: 406–13.

Gutierrez-Xicotencati L, Salazar-Piña DA, Pedroza-Saavedra A, Chihu-Amparan L, Rodriguez-Ocampo AN, Maldonado-Gama M, Esquivel-Guadarrama FR. Humoral immune response against human papillomavirus as source of biomarkers for the prediction and detection of cervical cancer. Viral Immunol. 2016; 29(2): 1-12.

Yunihastuti E. Infeksi HPV pada HIV. In: Adrijono, Indriatmi W, editors. Infeksi human papillomavirus. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2013. p. 183-6.

Mayeaux EJ, Dunton C. Modern management of external genital warts. J Low Genit Tract Dis. 2008; 12(3): 185-92.

Cistjakovs M, Sultanova A, Jermakova O, et al. Importance of High-Risk Human Papillomavirus Infection Detection in Female Renal Transplant Recipients in the First Year after Transplantation. Infect Dis Obstet Gynecol. 2018; 2018: 1-8.

Intaraphet S, Farkas DK, Schmidt SAJ, Cronin-Fenton D, Søgaard M. Human papillomavirus infection and lymphoma incidence using cervical conization as a surrogate marker: A Danish nationwide cohort study. Hemato Oncol. 2015; 35(2): 172-6.

Palefsky J. Human papillomavirus-related disease in people with HIV. Curr Opin HIV AIDS. 2009; 4(1): 52-6.

Reyes JFR, Rocha JAS, Gonzalez OCL, Varea JAH, Rodríguez PRL. Giant Cumulated Condyloma (Tumor of Buschke Lõwenstein) Presentation of a Case. J Surg Open Access. 2019; 5(3): 1–4.

Hum M, Chow E, Schuurmans N, Dytoc M. Case of giant vulvar condyloma acuminate successfully treated with imiquimod 3.75% cream: A case report. SAGE Open Med Case Reports. 2018; 6: 1-5.

Sandhu R, Min Z, Bhanot N. A gigantic anogenital lesion: Buschke-Lowenstein tumor. Case Rep Dermatol Med. 2014; 2014: 1-3.

Montaña N, Labra A, Schiappacasse G. Giant condyloma acuminatum (Buschke-Lowenstein tumor). Series of seven cases and review of the literature. Rev Chil Radiol. 2014; 20(2): 57-63.

Chan MP. Verruciform and condyloma-like squamous proliferations in the anogenital region. Arch Pathol Lab Med. 2019; 143: 821-31.

Pineda-Murillo J. Lugo-García JA, Martínez-Carrillo G, Torres-Aguilar J, Viveros-Contreras C, Schettino-Peredo MV. Buschke-Löwenstein tumor of the penis. Afr J Urol. 2019; 25(9): 1-4.

Purzycka-Bohdan D, Szczerkowska-Dobosz A, Swiatecka-Czaj J, Peksa R, Urban M, Szczypior M, Nowicki RJ. Buschke-Löwenstein tumour associated with low-risk human papillomavirus genotypes successfully treated surgically. Adv Dermatol Allergol. 2019; 36(1): 112–4.

Ahmed SMR, Islam MS, Ali SMY, Akhtar N, Hasan MS. Giant condyloma acuminatum of vulva. Bangabandhu Sheikh Mujib Med Univ J. 2017; 10: 169-72.


No Supplementary Material available for this article.
Article Views      : 76
PDF Downloads : 22