Genital human papilloma virus (HPV) infections are transmitted primarily through sexual contact, with a lifetime risk of 50-80% [
Here we present two cases with giant vulvar condylomas and their management with a review of the literature.
A 22-year-old sexually inactive woman presented with a rapidly growing mass in the vulva and perianal region. The lesions appeared 3 months before presentation and developed rapidly. The patient had no sexual activity. She was a regular smoker and the medical history included Type 1 diabetes mellitus for 15 years. The serologic screening for Hepatitis B (HBsAg), Hepatitis C (Anti-HCV), Human Immunodeficiency Virus (Anti-HIV), and syphilis (VDRL) was negative. Patient had no history of sexual diseases. On physical examination, a giant mass thought of as a giant condyloma, extending from the mons pubis till the anal mucosal lining and distorting the labial and clitoral anatomy was observed [Figure
The appearance of Case 1 with distortion of labial and clitoral anatomy.
The appearance of Case 1 immediately after surgical resection.
Postoperative appearance of Case 1.
Histology of giant condyloma of Case 1. (a) x4 magnification (b) x20 magnification.
A 20-year old sexually active woman presented with a giant vulvar mass involving the vulva and the anal area. Lesions began to develop 5 months before presentation and developed rapidly. Medical history was unremarkable. Serologic screening for Hepatitis B (HBsAg), Hepatitis C (Anti-HCV), Human Immunodeficiency Virus (Anti-HIV), and syphilis (VDRL) was negative. Patient had no history of sexually transmitted diseases. Physical examination of the patient revealed condylomatous masses extending from the lower perineum to the intergluteal folds [Figure
The appearance of Case 2 with main involvement of the anal region.
The appearance of Case 2 immediately after surgical resection.
The histology of giant condyloma of Case 2. (a) x2 magnification (b) x40 magnification.
Buschke-Loewenstein tumor is a sexually transmitted disease caused by HPV subtypes 6 and 11, with benign histological features, but with excessive local growth and high recurrence rates [
Rachman and Hasan reported a case of a 42-year-old woman presenting with giant vulvar condyloma diagnosed with systemic lupus erythematosus (SLE) one year ago and treated with surgical excision [
CostaPinto et al. reported a 33-year-old patient diagnosed with SLE during pregnancy presenting with giant vulvar condyloma after delivery [
Petrini et al. reported a case of a 16-year-old patient with alcohol consumption and illicit drug usage [
Main treatment of giant vulvar condylomas is surgical excision. Apart from the aesthetic appearance of giant vulvar condylomas and the difficulty of surgical treatment, it is even more important to note that vulvar verrucous carcinoma should be included in the differential diagnosis of giant vulvar condylomas. Zerkan et al. reported a case of giant vulvar condyloma, which was resistant to conservative treatment and operated five times. The definitive pathologic examination revealed superficial vulvar carcinoma [
In conclusion, giant vulvar condylomas, which are caused by low-risk HPV types and treated with surgery, should be distinguished from verrucous carcinoma. Local aggressively growing vulvar condylomata, are seen more often in women with immunosuppression and should be treated as soon as they are diagnosed.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
None of the authors have conflicts of interest.
Ugurlucan did the project development, data collection, and manuscript writing. Yasa performed data collection, manuscript writing. Demir did data collection, manuscript writing. Dural did data collection. Yavuz did data collection, manuscript writing. Akhan did project development, manuscript writing.