Contemporary Management of Buschke-Lowenstein Tumor Requiring Extensive Genitourinary Reconstruction

Objective: We present a case report of a patient with 10-year history of Buschke-Lowenstein tumor (BLT) and the extensive genitourinary reconstruction required to restore acceptable cosmesis and function in order to guide physicians in the evaluation and management of this disease when it is in the advanced stages. Methods: We performed a case report of a patient undergoing evaluation and treatment for Buschke-Lowenstein tumor at our institution. Results: A single case was evaluated. An acceptable cosmetic and functional outcome was achieved for the patient following extensive genitourinary reconstruction including resection of the tumor and suprapubic fat pad with complex scrotoplasty to provide adequate penile shaft coverage. Pathologic analysis was consistent with condyloma acuminatum. There has been no tumor recurrence at three-month follow up. The patient is currently ambulating without assistance and able to void without difficulty. Conclusion: Buschke-Lowenstein tumors can be treated using topical agents, cryotherapy, or by surgical excision. In the advanced stages, tumors can cause physical stressors, limiting patient mobility and compromising lower urinary tract function. Surgical excision and genitourinary reconstruction is the treatment of choice but presents significant challenges to the surgeon. We have demonstrated a surgical option that provides an acceptable cosmetic and functional outcome.