Candyloma or giant condyloma, Buschke-Lowenstein tumor, verrucous carcinoma or condyloma acuminata, characterized by an aggressive local proliferation of viral origin, specifically HPV, which destroys the tissues on which it resides. It represents 5 percent of penile tumors. It evolves very quickly. It looks like cauliflower. In general it has a benign prognosis but if there is a recurrence it can become malignant. Surgery is suggested as the most definitive therapeutic option for its resolution.
Causes of giant candiloma
Viral origin
The appearance of candyloma or giant condyloma is associated with a viral infection by human papillomavirus (HPV).
The main risk factors are:
– Unprotected sexual practices.
– Risky sexual practices.
– Sexual promiscuity.
– Compromised immune system.
There are four types of condylomas or genital warts:
– Condyloma acuminata, which takes the shape similar to a “cauliflower”.
– Papular warts measuring 1 to 4 millimeters in size that are soft to the touch and are generally skin-colored.
– Keratotic warts. Hard and calloused similar to common warts.
– Flat warts that look like papules.
Symptoms of giant candiloma
Cauliflower-shaped wart that evolves aggressively
The main sign of candyloma or giant condyloma or Buschke-Lowenstein tumor is a lesion or wart with a cauliflower appearance that evolves aggressively and destroys tissues. It usually starts in the balanopreputial region and in the foreskin. It then extends on the surface and in depth through the penis and scrotum, respecting the glans although it invades the corpora cavernosa. It ulcerates and destroys and fistulizes the urethra.
Diagnosis of giant candyloma
Physical exam and biopsy
The physical examination and tissue biopsy will allow a diagnosis of giant candyloma, ruling out other disorders that can cause warts in the genital area.
Treatment and medication for giant candyloma
Various therapeutic options
There are several therapeutic options to treat giant candyloma or Buschke-Lowenatein tumor. It can be treated locally with:
– Podofilino, a medication that is applied topically.
– Cryotherapy.
– Electrocoagulation
– Elimination surgery. It is the most recommended option. It may include reconstructive (plastic) surgery.
Prevention of giant candiloma
Sexual hygiene measures and vaccination against HPV
The prevention measures against giant condyloma are the same as those applied to other sexually transmitted diseases. Use condoms and avoid sexual relations (oral, vaginal or anal sex). These are absolutely mandatory measures until the problem is resolved.
Vaccination against HPV is also possible: the vaccination program can begin in pre-adolescence and adolescence, between 9 and 14 years of age. It is also possible to get vaccinated between 15 and 45 years of age. If the vaccine is administered between 9 and 14, only two injections will be needed with a six-month separation period between both administrations.
If the vaccine is given after the age of 15, three separate injections distributed over six months will be necessary.
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