Giant condyloma acuminatum of vulva

S M Ramiz Ahmed,Md Sajid Hasan,Mohammad Saiful Islam,Nargis Akhtar,S M Yunus Ali

doi:10.3329/bsmmuj.v10i3.32993

Abstract

<p>In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening). Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.</p>

Highlights

Condyloma acuminatum is a benign superficial skin manifestation accredited to the epidermotropic human papilloma virus (HPV) which is a double-stranded DNA virus belonging to the Papillomaviridae family
Infection of HPV begins at the basal cell layer of stratified squamous epithelial cells and stimulates cell proliferation in the epithelium
Patient was advised to give HPV quadrivalent (HPV4) 3 dose vaccines after HPV genotyping to prevent recurrence but patient was unable to bear that cost. Such a giant condyloma acuminatum with benign appearance which is a rare entity with an average incidence of 0.1% in the general population, steadily the number of cases increases in the last few decades but the prevalence of HPV infection is unknown in our country

Summary

Introduction

Condyloma acuminatum (genital wart or or veneral wart) is a benign superficial skin manifestation accredited to the epidermotropic human papilloma virus (HPV) which is a double-stranded DNA virus belonging to the Papillomaviridae family. On first follow-up (1 month after discharge), after examining the genital and perineal area, surgical wound was well healed but multiple small warts were found scattered in the vulval region, perineal region and around anus. With these clinical features she was again referred to the skin and veneral disease department for cryotherapy where 20 cycle. On subsequent 3 monthly followup 2015-2016, multiple relatively larger size warts were developed on the similar area during course of cryotherapy in each follow-up and treated surgically by diathermy cauterization (Figure 2). Patient was advised to give HPV quadrivalent (HPV4) 3 dose vaccines after HPV genotyping to prevent recurrence but patient was unable to bear that cost

Discussion

Findings

Conclusion