Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2023; 11(29): 7107-7112
Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7107
Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report
Fu-Chieh Hsu, Dah-Shyong Yu, Ta-Wei Pu, Min-Jui Wu, En Meng
Fu-Chieh Hsu, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
Dah-Shyong Yu, Min-Jui Wu, En Meng, Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
Ta-Wei Pu, Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114024, Taiwan
Author contributions: Hsu FC contributed to data collection and manuscript writing; Wu MJ and Meng E contributed to conceptualization and supervision; Yu DS and Pu DW contributed to manuscript revision and study supervision; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dah-Shyong Yu, MD, PhD, Attending Doctor, Doctor, Professor, Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec 2, Neihu Road, Neihu District, Taipei 114024, Taiwan. yuds45@gmail.com
Received: June 6, 2023
Peer-review started: June 6, 2023
First decision: August 30, 2023
Revised: September 8, 2023
Accepted: September 22, 2023
Article in press: September 22, 2023
Published online: October 16, 2023
Processing time: 129 Days and 3.1 Hours
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.