Buschke–Lowenstein tumour managed by wide excision and V-Y flap reconstruction: report of two cases

Buschke–Lowenstein tumour (giant condyloma acuminatum) is a rare sexually transmitted lesion associated with human papillomavirus infection, most commonly types 6 and 11. Although histologically benign, it demonstrates locally aggressive growth, high recurrence rates, and potential malignant transformation. We report two cases of large circumferential Buschke–Lowenstein tumours involving the anorectal region. Both patients presented with progressively enlarging exophytic lesions requiring surgical management. Wide local excision was performed in both cases, followed by reconstruction with bilateral V-Y advancement flaps due to extensive tissue defects. Histopathological examination confirmed giant condyloma acuminatum without evidence of dysplasia or invasive carcinoma. Postoperative recovery was uneventful and no early recurrence was observed during follow-up. These cases highlight the importance of complete surgical excision with adequate margins and appropriate reconstructive techniques in the management of extensive perianal Buschke–Lowenstein tumours.