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A rare case of Buschke–Lowenstein tumour of vulva treated with radical radiotherapy

Published online by Cambridge University Press:  02 December 2022

Sutanuka Chakrabarti Open the ORCID record for Sutanuka Chakrabarti [Opens in a new window] ,
Asmita Kulshrestha Open the ORCID record for Asmita Kulshrestha [Opens in a new window] ,
Sonal Patel Open the ORCID record for Sonal Patel [Opens in a new window] ,
Suryanarayana Kunikullaya Open the ORCID record for Suryanarayana Kunikullaya [Opens in a new window]  and
Ankit Sharma Open the ORCID record for Ankit Sharma [Opens in a new window]
Sutanuka Chakrabarti
Affiliation:
Department of Radiation Oncology, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India
Asmita Kulshrestha*
Affiliation:
Department of Radiation Oncology, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India
Sonal Patel
Affiliation:
Department of Radiation Oncology, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India
Suryanarayana Kunikullaya
Affiliation:
Department of Radiation Oncology, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India
Ankit Sharma
Affiliation:
Department of Surgical Oncology, Gujarat Cancer and Research Institute, Civil Hospital, Asarwa, Ahmedabad 380016, Gujarat, India
*
Author for correspondence: Dr. Asmita Kulshrestha, Department of Radiation Oncology, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India. Tel: 0091-9685994359. E-mail: asmi.kul@gmail.com
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Abstract

Introduction:

Buschke–Lowenstein tumour (BLT) is a rare verrucous lesion often associated with human papillomavirus infection. It is an indolent but locally aggressive lesion usually arising from the genitalia or anorectum, with a potential risk of recurrence and malignant transformation. The first line of management is surgical or laser excision. Topical agents cryotherapy, radiotherapy and chemo-immunomodulators are reserved for residual or recurrent cases and smaller lesions.

Methods:

A 24-year-old female on antiretroviral therapy presented in our department with a large cauliflower-shaped growth involving the perineum, vulva and lower vagina. A biopsy of the lesion was suggestive of a BLT. Due to the extensive nature of the disease, surgery was deferred. The lesion was treated with definitive external beam radiation therapy (EBRT) using a 6-megavoltage photon beam on a Cobalt-60 unit.

Results:

Radiotherapy resulted in a significant response without any acute toxicity, following which, topical podophyllin application was advised for the residual perianal lesion. The patient is disease free after 9 months of follow-up.

Conclusions:

A multidisciplinary approach is important to treat the BLT. Lesions not amenable to surgery or local therapies can be treated with EBRT with reasonable control and acceptable toxicities.

Keywords

Buschke–Lowenstein tumourHIVradiation therapyvulva
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e64
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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