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Malignant Transformation of Perianal Giant Condyloma Acuminatum

肛周區尖形濕疣惡性變化:一病例報告

摘要


巨大尖形濕疣,或可稱之為Buschke-Lowenstein腫瘤,其特色是大的腫瘤外觀而且有浸犯到下層組織的傾向,雖然病理學上是良性的組織。此疾病通常發生在生殖器區。肛門周邊巨大尖形濕疣在英文醫學文獻上偶有報導。然而在台灣,到目前為止,只有一例的肛門周邊巨大尖形濕疣被報導。在此我們報導一位五十六歲已婚的非同性戀者被診斷有肛門周邊巨大尖形濕疣。疣狀腫瘤大小有十公分乘六公分乘四公分,在肛門周邊並且往左側臀部侵犯。初次於民國九十三年九月接受簡單切除及電灼燒治療。當時病理報告是巨大尖形濕疣無惡性成份。然而一年後因為復發腫瘤再次接受手術。手術方法是廣泛式切除。病理報告是巨大尖形濕疣含有惡性疣狀癌成份。傷口於三個月後以次級癒合機轉癒合。術後十五個月追蹤沒有發現任何尖形濕疣復發。也沒有肛門狹窄或失禁的情形發生。

並列摘要


Giant condyloma acuminatum or Buschke-Lowenstein tumor is characterized by its large size and is prone to infiltrating into underlying tissues although it is microscopically benign. It commonly affects the genitalia. Cases of perianal giant condyloma acuminatum are reported sporadically in the English literature. In Taiwan, only one case of perianal giant condyloma acuminatum was found in literature. We report a rare case of perianal giant condyloma acuminatum in a 56-year-old, non-homosexual, married man. There was a 10-cm × 6-cm × 4-cm fungating circum-anal mass extending into his left buttock. He initially received simple excision and electrofulgaration in Sep 2004. Pathology did not reveal evidence of malignancy. However, one year later, he received wide local excision for recurrent lesion. Pathology demonstrated malignant transformation with verrucous carcinoma. Three months later, wound healed by secondary intention. After follow-up for fifteen months, no anorectal condyloma has been found with examination under anesthesia. The patient had no anal stenosis or incontinence.

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