Malignant potential of gigantic condylomatous lesions of the vulva

A diagnostic and therapeutic approach in the identification of malignant le sions and the types of HPV in 11 patients with gigantic condylomatous vulva r protuberances is presented. Different histological types of squamous cell vulvar carcinoma have been found in 8 (72.7%) cases: condylomatous (4), ve rrucous (3) and basaloid type of the carcinoma (1). HPV type 16, confirmed in 5 cases, was most often present (4 condylomatous and 1 basaloid carcinom a types). Other types of HPV such as HPV-6 was detected in 3 cases of verru cous, type 11 in 2 cases of verrucous and condylomatous carcinoma and type 18 in 1 case of condylomatous carcinoma. Radical vulvectomy followed by bil ateral inguinofemoral lymphadenectomy was performed in 4 patients with cond ylomatous carcinoma, hemivulvectomy in basaloid carcinoma whereas wide loca l excision was performed in the verrucous type of carcinoma. No patient die d except 1 with condylomatous carcinoma in whom 6 positive lymph nodes were detected after the primary operation. The patient died 3 years later follo wing 3 excisions of local recurrences.