What Is a Buschke-Löwenstein Tumor? Symptoms, Causes, and Treatment for a Rare HPV-Linked Growth
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
A Buschke-Löwenstein tumor is a benign, cauliflower-like growth caused by low-risk HPV (types 6 and 11) that forms on the genitals or around the anus. It is not cancer, but it is locally aggressive, can grow very large, and can transform into cancer if untreated. Surgery is the main treatment, and because recurrence exceeds 60%, ongoing monitoring is required. [7]
Key takeaways
A Buschke-Löwenstein tumor is a rare, benign, cauliflower-like growth on the genitals or around the anus, also called giant condyloma acuminatum. [7]
Low-risk HPV strains HPV-6 and HPV-11 cause it; it mostly occurs in males. [7] [4]
The tumor is locally aggressive: it doesn't spread, but it can damage nearby tissue and can turn into cancer (squamous cell carcinoma) without treatment. [7]
Most grow slowly over 3–10 years, but a weakened immune system (organ transplant drugs, HIV, immune deficiencies, smoking) speeds growth. [7]
The tumor itself isn't contagious, but the HPV infection behind it spreads through sexual contact. [7]
Surgery is the main treatment; chemotherapy or radiation may shrink very large tumors first; immunotherapy creams like imiquimod help the immune system fight HPV but can't cure the condition. [7]
Recurrence exceeds 60% [6], so close follow-up monitoring is essential. [7]
Prevention: safer sex practices (condoms, fewer partners) and the HPV vaccine, which protects against HPV-6 and HPV-11. [7]
What the research says
Bigger tumors are more likely to contain invasive cancer. In a pathology study of 78 large anal condylomas (2 cm or larger; mean patient age 38, 70 men and 8 women), invasive carcinoma was found in 14% overall — 8.5% of medium-large lesions (2–5 cm), 23% of large lesions (5–10 cm), and 50% of giant lesions (over 10 cm) (p = 0.02) (Taskin et al., Turk Patoloji Derg, 2021) [1].
Cancer arising from a giant condyloma has been documented and calls for clean surgical margins. A systematic review of 55 articles covering 97 patients found carcinoma arising from giant perianal condyloma acuminatum — squamous cell carcinoma in 56 patients and verrucous carcinoma in 19 — with a median patient age of 49.6 years (75 men, 20 women). The authors stress removing the tumor with clean surgical margins even when it looks benign (Ates et al., J Gastrointest Cancer, 2022) [2].
Large reviews do not support a high cancer or death rate. A review of every published study from 1925 to 2020 concluded that these lesions are caused by HPV and are distinct from verrucous carcinoma, and it refuted the claim that they carry a high mortality or malignancy rate. Because no accepted definition exists, the authors proposed a simple grading system (Davis et al., Sex Transm Dis, 2021) [3].
What Is a Buschke-Löwenstein Tumor?
A Buschke-Löwenstein tumor is a rare, noncancerous growth that forms on your genitals or the area around your anus. It's also called giant condyloma acuminatum. It mostly occurs in males and is linked to human papillomavirus (HPV) infection. [7]
Even though they're not cancer, they can be locally aggressive. This means that they don't spread, but as they grow, they can damage nearby tissue. In some cases, they may turn into cancer. [6] [7] [4]
If you have this tumor, your healthcare provider will work to remove it safely. Afterward, they'll monitor you closely for recurrence, as these tumors often grow back. [7] If it does, they'll act fast to get rid of it.
What Are the Symptoms of a Buschke-Löwenstein Tumor?
The most obvious sign is a cauliflower-like growth on your genitals or anus. Although it's sometimes called a "giant" condyloma acuminatum, it can come in all sizes. Studies show they can grow bigger than 10 centimeters (about 4 inches) in diameter. [7] For reference, most oranges range in size from 2 to 4 inches in diameter.
As they grow, they can cause symptoms:
Symptom | What to expect |
Cauliflower-like growth | The most obvious sign — a bumpy mass on the genitals or around the anus, in any size |
Discomfort | Growing tissue presses on and irritates nearby areas |
Bleeding | The mass may bleed as it enlarges |
How Fast Do They Grow?
Most grow slowly. [6] It may take around three to 10 years for a tumor to form. But this depends on your health, too. If you have a weakened immune system (immunocompromised), the tumor can grow faster. [7]
What Causes a Buschke-Löwenstein Tumor?
Low-risk strains of the human papillomavirus — HPV-6 or HPV-11 — cause it. [7] [4] HPV is a common sexually transmitted infection that can spread to the skin in and around the genitals through skin-to-skin contact.
Most low-risk types of HPV cause conditions that aren't serious, like genital warts. High-risk types are more likely to cause serious conditions, like cervical cancer. A Buschke-Löwenstein tumor is an exception: even though low-risk HPV causes it, it can grow large and cause serious health problems, so it needs treatment.
HPV type | Typical results | Buschke-Löwenstein tumor? |
Low-risk (HPV-6, HPV-11) | Non-serious conditions like genital warts | Yes — an exception; can grow large and cause serious problems |
High-risk | Serious conditions like cervical cancer | No — different strains |
Are Buschke-Löwenstein Tumors Contagious?
No. But the HPV infections that cause them can be transmitted through sexual contact. [7]
Having an HPV infection doesn't mean you'll develop a tumor. [7] Medical experts are researching why some people with HPV get this condition while others don't. For now, experts know that people with HPV-6 or HPV-11 infections with weakened immune systems are at greatest risk:
Risk factor | Why it raises risk |
Born with conditions that cause immune deficiencies | Harder for the body to fight off viruses like HPV |
Taking medicines to suppress the immune system after an organ transplant | Immunosuppressants reduce the body's ability to control HPV |
HIV-positive | HIV weakens the immune system |
Smoking | Smoking weakens immune defenses against viruses |
Can It Cause Complications?
Without treatment, these tumors can progress to squamous cell carcinoma, a type of skin cancer. [7] This is another reason why it's important to see a healthcare provider if you think you might have one. Early treatment can prevent damage from the tumor and reduce your cancer risk.
How Is a Buschke-Löwenstein Tumor Diagnosed?
Your healthcare provider will do a physical exam to diagnose a Buschke-Löwenstein tumor. You may also need:
Test | What it checks |
Physical exam | Visual identification of the cauliflower-like growth |
HPV test | Confirms presence of HPV infection |
HIV test | Checks for HIV, a key risk factor |
Biopsy | Checks for cancer cells |
Genetic tests | Checks for immune deficiency conditions |
CT scan or MRI | Checks the extent of tumor growth |
How Is a Buschke-Löwenstein Tumor Treated?
The main treatment for a Buschke-Löwenstein tumor is surgery. [6] For especially large tumors, you may need chemotherapy or radiation therapy beforehand to shrink it. [7]
The goal of surgery is to remove the entire tumor while protecting nearby structures that allow you to poop, pee, and have sex. Depending on how much tissue is removed, you may need reconstructive surgery afterward. [7] [5]
Your healthcare provider may also prescribe immunotherapy drugs or creams, like imiquimod (Aldara, Zyclara). They can't cure the condition. But they can help your immune system fight the HPV virus. [7]
Treatment | When it's used | What it does |
Surgery | Main treatment for all tumors | Removes the entire tumor while protecting urinary, bowel, and sexual function |
Chemotherapy or radiation | Before surgery for especially large tumors | Shrinks the tumor to make surgery more manageable |
Reconstructive surgery | After surgery, depending on tissue removed | Restores function and appearance of the affected area |
Immunotherapy drugs or creams (imiquimod) | Alongside other treatment | Helps the immune system fight HPV — cannot cure the condition |
When Should I See My Healthcare Provider?
Always see a healthcare provider if you find new lumps or bumps that are changing. Many people with this condition delay seeing a provider because they're embarrassed. But HPV is incredibly common. Providers know that HPV can cause growths in sensitive areas, and they're used to treating them.
Seeing a provider as soon as possible can get rid of the tumor before it grows so big that you'll need more extensive surgery. [7]
What Can I Expect If I Have This Condition?
Surgery gets rid of the tumor for most people. But it has a recurrence rate that's over 60% — tumors grow back in more than 6 out of 10 people. [6] [7]
Your healthcare provider will monitor you to check for signs the tumor has returned. If it does, they can provide treatment to get rid of it for good.
Outcome | What to know |
Surgery success | Gets rid of the tumor for most people |
Recurrence rate | Over 60% — more than 6 out of 10 people see it grow back |
Follow-up | Close monitoring so returning tumors are caught and treated early |
Can I Prevent a Buschke-Löwenstein Tumor?
The best way to prevent it is to use the same safer sex practices to reduce your risk of contracting HPV. This may mean using condoms and limiting your number of sexual partners. [7]
Another option is to get the HPV vaccine. It protects against the strains of HPV that cause it: HPV-6 and HPV-11. [7] Ask your healthcare provider if they think you'd benefit from this vaccine.
A note worth remembering — most of us would prefer not to have anyone, including a healthcare provider, inspect our genitals. But if you have a Buschke-Löwenstein tumor, it's essential for your provider to know about it. These masses aren't cancer, but they can become cancerous without treatment. They can grow big enough to cause harm. Surgery to remove the tumor early on can keep this from happening. And close monitoring afterward can ensure you get the treatment you need if it grows back.
Conclusion
A Buschke-Löwenstein tumor is a rare, benign, cauliflower-like growth on the genitals or around the anus caused by the same low-risk HPV strains (HPV-6 and HPV-11) responsible for genital warts. What sets it apart is its behavior: although it isn't cancer, it's locally aggressive, growing slowly over three to ten years, damaging nearby tissue, and in some cases transforming into squamous cell carcinoma. The main treatment is complete surgical removal, sometimes preceded by chemotherapy or radiation for very large tumors, with immunotherapy creams like imiquimod supporting the immune system's fight against HPV. Because recurrence exceeds 60%, close monitoring after treatment is non-negotiable. Early, honest conversations with a provider — despite any embarrassment — make all the difference, and safer sex practices plus the HPV vaccine remain the strongest shields.
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Frequently Asked Questions
What is a Buschke-Löwenstein tumor?
A rare, noncancerous growth that forms on the genitals or the area around the anus. It's also called giant condyloma acuminatum.
What is giant condyloma acuminatum?
Another name for a Buschke-Löwenstein tumor — a benign, cauliflower-like growth linked to HPV infection.
Is a Buschke-Löwenstein tumor cancer?
No. It's noncancerous (benign), but it's locally aggressive and can damage nearby tissue as it grows. In some cases, it may turn into cancer.
What causes a Buschke-Löwenstein tumor?
Low-risk strains of human papillomavirus — HPV-6 or HPV-11 — cause it.
Does HPV always cause a tumor?
No. Having an HPV infection doesn't mean you'll develop a tumor. Experts are researching why some people with HPV get this condition while others don't.
How does HPV spread?
HPV is a common sexually transmitted infection that can spread to the skin in and around the genitals through skin-to-skin contact.
Is the tumor itself contagious?
No. But the HPV infections that cause them can be transmitted through sexual contact.
Who gets Buschke-Löwenstein tumors?
A Buschke-Löwenstein tumor mostly occurs in males. People with HPV-6 or HPV-11 infections who also have weakened immune systems are at greatest risk.
What is the difference between low-risk and high-risk HPV?
Most low-risk types of HPV cause conditions that aren't serious, like genital warts. High-risk types are more likely to cause serious conditions, like cervical cancer.
Why is this tumor an exception among low-risk HPV conditions?
Even though low-risk HPV causes it, a Buschke-Löwenstein tumor can grow large and cause serious health problems, so it needs treatment.
What does a Buschke-Löwenstein tumor look like?
A cauliflower-like growth on the genitals or anus. Despite the "giant" name, it can come in all sizes.
How big can a Buschke-Löwenstein tumor get?
Studies show they can grow bigger than 10 centimeters (about 4 inches) in diameter — comparable to the size of an orange.
What symptoms does it cause?
As it grows, it can cause discomfort and bleeding, along with the visible cauliflower-like mass.
How fast does it grow?
Most grow slowly. It may take around three to 10 years for a tumor to form.
What makes the tumor grow faster?
A weakened immune system (being immunocompromised) allows the tumor to grow faster.
Who is at greatest risk?
People with HPV-6 or HPV-11 infections with weakened immune systems — including people born with immune deficiency conditions, organ transplant recipients on immunosuppressants, people who are HIV-positive, and people who smoke.
Why do these conditions raise risk?
They make it harder for your body to fight off viruses like HPV.
Can a Buschke-Löwenstein tumor become cancer?
Yes. Without treatment, these tumors can progress to squamous cell carcinoma, a type of skin cancer.
Why is early treatment important?
Early treatment can prevent damage from the tumor and reduce your cancer risk.
How is it diagnosed?
A provider does a physical exam. You may also need an HPV test, HIV test, biopsy, genetic tests, and a CT scan or MRI.
What does the biopsy check for?
Cancer cells.
What do genetic tests check for?
Immune deficiency conditions that raise your risk.
What do CT scans or MRIs check for?
The extent of tumor growth.
How is a Buschke-Löwenstein tumor treated?
The main treatment is surgery. For especially large tumors, you may need chemotherapy or radiation therapy beforehand to shrink it.
What is the goal of surgery?
To remove the entire tumor while protecting nearby structures that allow you to poop, pee, and have sex.
Will I need reconstructive surgery?
Depending on how much tissue is removed, you may need reconstructive surgery afterward.
What is imiquimod?
An immunotherapy cream (sold as Aldara or Zyclara) that helps your immune system fight the HPV virus. It cannot cure the condition.
Can immunotherapy creams cure the tumor?
No. They help your immune system fight the HPV virus, but they can't cure the condition.
Does the tumor come back after surgery?
Often, yes. The recurrence rate is over 60%, meaning tumors grow back in more than 6 out of 10 people.
What happens if the tumor grows back?
Your provider will act fast to get rid of it and can provide treatment to get rid of it for good.
Should I wait and see if the tumor goes away on its own?
No. Because these tumors are locally aggressive and can become cancerous without treatment, you should see a provider promptly. Seeing a provider early can prevent the need for more extensive surgery.
Why do people delay seeing a provider?
Many people delay because they're embarrassed. But HPV is incredibly common, and providers are used to treating growths in sensitive areas.
Can I prevent a Buschke-Löwenstein tumor?
Yes. The best prevention is safer sex practices to reduce your risk of contracting HPV — using condoms and limiting your number of sexual partners.
Does the HPV vaccine protect against this tumor?
Yes. The HPV vaccine protects against the strains that cause it: HPV-6 and HPV-11. Ask your provider if you'd benefit from it.
What happens after treatment?
Your provider monitors you closely for recurrence. If the tumor returns, treatment can get rid of it.
What should I do now?
If you've noticed a new, changing lump or bump in your genital or anal area, see a healthcare provider promptly — early evaluation leads to simpler treatment. If you're sexually active, ask your provider about the HPV vaccine and safer sex practices to reduce your risk.
Related Reading
HPV Infection: What It Is, the Four Types of Warts, and How It Is Treated
Genital Warts: What Causes Them, How They're Treated, and Why the HPV Vaccine Matters
Squamous Cell Carcinoma of the Skin: Symptoms, Causes, and Treatment Explained
Sexually Transmitted Diseases (STDs) Guide: Symptoms, Causes, Diagnosis, and Treatment
References
Taskin OC, Pehlivanoglu B, Reid MD, et al. Löwenstein-Buschke: clinicopathologic analysis of 78 cases of large and giant condyloma acuminata of the anus. Turk Patoloji Derg. 2021;37(1):18-25. PMID: 33021736. https://doi.org/10.5146/tjpath.2020.01508
Ates M, Akbulut S, Tuncer A, et al. Squamous cell carcinoma arising from perianal Buschke-Lowenstein tumor (giant condyloma acuminatum): comprehensive literature review. J Gastrointest Cancer. 2022;53(4):1083-1092. PMID: 34694593. https://doi.org/10.1007/s12029-021-00713-y
Davis KG, Barton JS, Orangio G, et al. Buschke-Lowenstein tumors: a review and proposed classification system. Sex Transm Dis. 2021;48(12):e263-e268. PMID: 33833150. https://doi.org/10.1097/OLQ.0000000000001437
Purzycka-Bohdan D, Nowicki RJ, Herms F, et al. The pathogenesis of giant condyloma acuminatum (Buschke-Lowenstein tumor): an overview. Int J Mol Sci. 2022;23(9):4547. PMID: 35562936. https://doi.org/10.3390/ijms23094547
Barrow BE, Ansah KO, Naga HI, et al. Giant condyloma acuminatum: a review of reconstructive options. Ann Plast Surg. 2025;94(6):695-700. PMID: 40209884. https://doi.org/10.1097/SAP.0000000000004349
Farach AM, Paradise E, Kieser RB. Treatment of a Buschke-Löwenstein tumor with radiotherapy and cemiplimab. JAMA Dermatol. 2025;161(3):336-338. PMID: 39813022. https://doi.org/10.1001/jamadermatol.2024.5826
Cleveland Clinic. Buschke-Löwenstein tumor. Cleveland Clinic Health Library. Last updated July 20, 2026. https://my.clevelandclinic.org/health/diseases/buschke-lowenstein-tumor
Medical disclaimer
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition. If you find a new or changing lump in your genital or anal area, see a healthcare provider promptly, as early treatment reduces the risk of serious complications.
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