Radical excision of inguinal condyloma acuminatum following 51 years of untreated growth, found to be squamous cell carcinoma

Abstract

Giant condyloma acuminatum, caused by herpes simplex virus infection, is a large cauliflower shaped lesion that has a propensity to infiltrate surrounding tissues with paradoxically benign microscopic/histological appearance. This lesion is often benign, though it does have the potential for malignant transformation. Here we present a case that demonstrates this potential and describes the pathological and histological findings in detail. The report concludes with the clinical reasoning for considering surgical resection in these patients.

Keywords: Condyloma; HSV; Pathology slides; Squamous cell carcinoma.

Fig. 1

Intraoperative pictures showing the condyloma retracted and the margins after excision. The satellite lesion is seen on the scrotum superomedial to the primary lesion.

Fig. 2

In situ well differentiated squamous carcinoma, A. Low power view of the lesion, keratin pearl is seen (arrow); B&C. High power view shows increased N/C ratio, pleomorphic epithelial cell with increased mitotic figures (arrow); D. Background of seborrhoic keratosis; E. Ki-67 index (proliferation index) reveals focal full thickness staining in the lesion, note that staining pattern is nuclear; F. p16 immunochemical stain displays en block full thickness positivity; correlates with oncogenic HPV infection.