Penis and scrotum
Benign tumors
Giant condyloma acuminatum

Authors: Antonio Cubilla, M.D., Alcides Chaux, M.D. (see Authors page)

Revised: 2 April 2018, last major update February 2010

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Giant condyloma acuminatum penis

Cite this page: Cubilla, A., Chaux, A. Giant condyloma acuminatum. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumgiantcondy.html. Accessed September 22nd, 2018.
Definition / general
Terminology
  • Also called Buschke-Löwenstein tumor
  • Also called verrucous carcinoma by some authors but most authors consider them to be separate entities
Epidemiology
  • Patients tend to be older than those with condyloma acuminatum
Sites
  • Usually involves foreskin and coronal sulcus; also glans, perianal region
Etiology
  • Low risk genotypes (HPV 6 and 11) predominate
Clinical features
  • Associated with poor hygiene in uncircumcised men
  • Intermediate properties between condyloma and warty carcinoma - tends to recur locally and destroy surrounding tissue
  • Malignant transformation may occur after many years
Treatment
  • Radical surgical excision allows a complete histological examination and assessment of tumor free resection margins (Dermatology 2009;218:56)
  • Also chemoradiation, intralesional interferon treatment for condyloma
Clinical images

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Perianal tumor - cauliflower-like mass

Pre and post intralesional interferon

Gross description
  • 5 - 10 cm cauliflower-like verruciform tumor with cobblestone surface
  • Cut surface shows papillomatous growth with sharp demarcation from underlying stroma
  • Cutaneous fistulae sometimes observed
Gross images

Images hosted on PathOut server:

Massive multinodular exophytic mass

Microscopic (histologic) description
  • Resembles condyloma (papillae with prominent fibrovascular cores, koilocytosis, broad pushing base) but with more prominent bulbous expansion into underlying tissue
  • Characteristically exhibits an endophytic pattern of growth and can invade deep anatomical tissues
  • Atypia or malignant change (in situ or invasive squamous cell carcinoma) may also be present
Microscopic (histologic) images

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Features of condyloma



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Papillomatous tumor with few koilocytes

Band-like mononuclear infiltrate

Differential diagnosis
  • Carcinoma cuniculatum: no koilocytosis, verrucous features and endophytic burrowing pattern of growth
  • Papillary carcinoma: no koilocytosis, complex papillae with irregular fibrovascular cores and definite invasion
  • Verrucous carcinoma: no koilocytosis, no prominent papillae with fibrovascular cores; pushing tumor base
  • Warty carcinoma: probably related, has clearly malignant histology and jagged borders with stroma