Buschke-Lowenstein tumor: therapeutic options including systemic chemotherapy.

Verrucous carcinoma of the penis (Buschke-Lowenstein tumor) is a rare variant of squamous cell carcinoma which has been reported to have limited potential for metastatic disease. We report on 2 patients who presented with locally advanced disease after prolonged intervals of neglect. In both cases, the disease was locally aggressive with extensive tissue destruction. In 1 patient, after failure to achieve tumor control with repeated aggressive surgical excision, systemic chemotherapy using bleomycin, cisplatin, methotrexate, and leucovorin led to a complete pathologic response. We believe this is the first reported case in which systemic chemotherapy has been used to successfully treat verrucous carcinoma of the penis. Surgical excision alone was successful in achieving local disease control in the second patient.