Tuesday, 2 August 2016

Glucan Therapy

                                                         
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Giant condyloma acuminatum or Buschke-Löwenstein tumor (BTL) is a slow-growing, locally aggressive and disfiguring cauliflower-like tumor that typically affects the anogenital and perianal regions. BTL is a rare HPV-induced squamous cell carcinoma. It was first described in 1925 by Buschke and Löwenstein as a benign carcinoma-like condyloma acuminatum. Despite being histologically classified as a non-malignant tumor, malignant transformation can occur in 40-60% of cases and the recurrence rate after treatment can be as high as 67% . We report the case of a 31-year-old female patient with a history of  vulvar lesio

                                                            A 31-year-old woman, two previous cesarean sections, first
coitus at age 14 and 5 sexual partners during lifetime with non-compliance of condom use and no sexual partner at the time of the investigation presented with a giant condyloma acuminatum with concomitant bacterial infection. Physical examination showed exophytic tumor on the mons pubis, labia majora, labia minora, vaginal introitus, perineum and anus. The patient reported a small warty lesion in the vulvar region one year ago associated with difficulty in defecation and sexual intercourse. She did not report weight loss and she was afebrile and hemodynamically stable. The patient was screened for HIV, syphilis and hepatitis B and C infections and the results were nonreactive. Clinical and cytological evaluations of the cervix and vagina could not be performed by the time of admittance because of mechanical obstruction.


Since most of the exophytic lesions have a pedicled base, surgical excision of the condyloma was performed by fusiform incision with a safety margin of 0.5 cm. The wound was sutured by approximation of wound margins and the perineum was healed by second intention. During the surgery a pap smear was sampled and clinical evaluation was performed. There were no macroscopic lesions in the cervix or vagina.

Postoperatively, the patient developed dehiscence of the skin suture with secondary bacterial infection. Intravenous antibiotic therapy administered included cefalotin, metronidazole and garamycin, along with local application of potassium permanganate and four daily bandages embedded with DersaneSince most of the exophytic lesions have a pedicled base, surgical excision of the condyloma was performed by fusiform incision with a safety margin of 0.5 cm. The wound was sutured by approximation of wound margins and the perineum was healed by second intention. During the surgery a pap smear was sampled and clinical evaluation was performed. There were no macroscopic lesions in the cervix or vagina.

Postoperatively, the patient developed dehiscence of the skin suture with secondary bacterial infection. Intravenous antibiotic therapy administered included cefalotin, metronidazole and garamycin, along with local application of potassium permanganate and four daily bandages embedded with Dersane

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