Extensive Buschke–Löwenstein tumor of the scrotum and perineum: A case report

Buschke–Löwenstein tumor (BLT), also known as giant condyloma acuminatum, is a rare sexually transmitted disease associated with human papillomavirus infection, most commonly types 6 and 11. Although histologically benign, BLT demonstrates locally aggressive behavior with a high risk of recurrence and potential malignant transformation. We report the case of a 54-year-old man presenting with a 9-year history of progressive scrotal and perineal condylomatous lesions. Pelvic magnetic resonance imaging revealed a large exophytic cutaneous mass without deep tissue invasion. Complete surgical excision was performed, removing a cauliflower-like tumor measuring 14 × 6 × 5 cm. Histopathological examination showed papillomatosis, hyperkeratosis, acanthosis, and numerous koilocytes, consistent with condyloma acuminatum, without evidence of invasive carcinoma or high-grade dysplasia. Surgical margins were free of tumor. Due to wound tension, healing occurred by secondary intention with favorable postoperative evolution. No recurrence was observed after 10 months of follow-up. This case highlights the importance of imaging in assessing tumor extension and planning surgery, as well as the essential role of complete surgical excision in the management of extensive BLT lesions.