Introduction. Giant condyloma acuminatum or Buschke Lowenstein tumor (B.L.t.) of the anorectal and perianal regions is an uncommon entity. These are slow-growing, espansive, cauliflower-like, destructive lesions. It presents an high rate of recurrence (66%) and malignant transformation (56%). 52% of cases have extensive and infiltrative involvement to the sorrounding tissues. No distant MTS usually occur. Materials and methods. 3 patients were diagnosed with a B.L.t.. In 2 cases immunodeficiency was evidentiated. The lesions were up to 15 cm of diameter. All patients were studied with proctoscopy, CT scan, MRI and limphoscintigraphy for following biopsy of inguinal sentinel node for potential malignancy. They were sumbitted to extensive local surgical treatment. Results. No mortality was observed. In one case we observed an anal stenosis treated with local dilatations. One pt. with a small persistence of the disease was treated with cryotherapy and electrocautery. Conclusions. B.L.t. are rare but extensive lesions. Wide local excision is the first treatment, even if APR sec. Miles could be considered in case of extremely extensive lesions or multiple recurrences.
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