Penis & scrotum
Infectious
Giant condyloma acuminatum
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Last author update: 1 February 2010
Last staff update: 30 August 2022
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Giant condyloma acuminatum penis
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Chaux A, Cubilla AL. Giant condyloma acuminatum. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumgiantcondy.html. Accessed September 28th, 2023.
Definition / general
- Very rare, slow growing but locally destructive HPV related verruciform tumor (eMedicine: Giant Condylomata Acuminata of Buschke and Lowenstein [Accessed 2 April 2018])
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
Images hosted on other servers:
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
AFIP images
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
AFIP images
Features of condyloma
Images hosted on other servers:
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
