ArticleRadiology case reports2026
MRI assessment of locoregional extent in a Buschke-Löwenstein tumor with histopathologically confirmed malignant transformation: A case report.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The Buschke-Löwenstein tumor (BLT), also designated giant condyloma acuminatum, represents a rare anogenital neoplasm of intermediate biological behavior, occupying a nosological boundary between benign condylomatous disease and invasive squamous cell carcinoma (SCC). Its malignant transformation potential, estimated between 30% and 56%, renders early diagnosis and accurate locoregional staging of paramount clinical importance. We report the case of a 54-year-old immunocompetent male who presented with a 2-year history of a progressively enlarging scrotal mass, ultimately measuring 12 cm at clinical assessment. Physical examination disclosed a large exophytic cauliflower-shaped lesion with surface ulceration, malodorous discharge, and bilateral inguinal lymphadenopathy. Pelvic MRI revealed a heterogeneous scrotal mass with posterior extension into the ipsilateral intergluteal fold and perineal soft tissues. Post-contrast T1-weighted sequences demonstrated avid heterogeneous enhancement. Diffusion-weighted imaging yielded a markedly reduced mean apparent diffusion coefficient value of 0.9 × 10⁻³ mm²/s within the inguinal lymph nodes, a finding supportive of, though not independently diagnostic of, nodal metastatic involvement, which was subsequently confirmed by fine-needle aspiration cytology. Histopathological examination of the surgical specimen identified a dual pattern comprising benign condylomatous areas alongside foci of invasive moderately differentiated SCC, confirming malignant transformation. This case underscores the oncological risk inherent to long-neglected anogenital condylomatous lesions and highlights the pivotal contribution of pelvic MRI-particularly diffusion-weighted sequences with ADC quantification-in delineating locoregional tumor extent, raising suspicion for nodal metastatic involvement, and guiding surgical planning in the management of Buschke-Löwenstein tumor.
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