Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report

Abstract

BACKGROUND

Giant condyloma acuminatum (GCA) is an uncommon condition affecting the anogenital area.

CASE SUMMARY

Here, we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft, pubis region, and groin as well as urine leakage along the distal penile shaft. Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base, which was initially suspected to be a urethral fistula. However, during surgery, it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening, with infection and high pressure causing subsequent skin perforation. He underwent circumcision and wide excision with electrocauterization of the warts. He was discharged after the surgery, and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil.

CONCLUSION

Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.

Keywords: Giant condyloma acuminatum; Prepuce perforation; Buschke-Löwenstein tumor; Fistula; Foreskin; Case report

Core Tip: This case report highlights a rare presentation of a giant condyloma acuminatum (GCA) in an elderly male patient. The patient presented with progressive, cauliflower-like warts on the penile shaft, pubis region, and groin, accompanied by urine leakage and an ulcerative skin perforation with pus discharge under the prepuce. Surgery revealed that the perforation was caused by an obliterative giant condyloma lesion, mimicking urethral rupture. The patient underwent circumcision, wide excision of warts, and tailored subsequent treatment with favorable outcomes. This case emphasizes the importance of individualized treatment for GCA and the successful management of spontaneous prepuce perforation.