Giant condyloma acuminatum (Buschke-Lowenstein tumour)

History and admission findings: A 59-year-old woman had for 3 weeks been su ffering from painful, moist skin changes on the external genitals, for 3 mo nths having noticed vegetations in the anogenital and perineal region. She had been fatigued and lacking in energy since then. Her last gynecological examination had been 20 years ago. Examination of the skin on admission rev ealed extensive plaque and cauliflower-like warts and large areas of macera tion in the anogenital region, the labia and perineum, with large areas of maceration. Nodules were clearly palpable in the left labium majora: the in ner aspects were marltedly reddened and had some cutaneous erosions. These findings suggested giant condyloma (GC; Buschlte-Lowenstein tumour). Investigations: Biopsy showed marked condylomatous epithelial proliferation s which, with the formation of marltedly thickened epithelial cones, had re ached the stage of a verrucous carcinoma. Treatment and course: Under local anti-inflammatory and ad-stringent medica tions the inflammatory reaction quickly subsided. Vulvectomy was performed to remove the tumour. Conclusion: Giant condyloma (Buschke-Lowenstein tumour) is a rare pseudocan cereous lesion. If human papilloma viruses of type 16 or 18 is demonstrated in the lesions, malignant degeneration should be considered. Histological examination is essential to differentiate it from squamous cell carcinoma.