Giant condyloma acuminatum of the scrotum in a man with AIDS: a case report

Abstract

IntroductionGiant condyloma acuminatum, also called a Buschke-Löwenstein tumor, first described in 1925, is a slow-growing, locally aggressive, destructive tumor of the ano-genital region. Scrotal tumors are rare. Reports on giant condyloma acuminatum lesions in patients with HIV and AIDS are surprisingly even rarer.Case presentationIn this report, we present the case of a 42-year-old African man with AIDS who was undergoing anti-retroviral therapy. He was found to have a giant condyloma acuminatum of the scrotum. Wide surgical excision and scrotal reconstruction with a pedicled anterolateral thigh flap was performed, significantly improving his quality of life.ConclusionDecision making regarding the goals of surgical intervention in the terminally ill is a complex process. The options include conservative medical palliation or palliative excision versus a curative excision that has the potential for significant morbidity. Wide surgical excision with local flap reconstruction significantly improved the quality of life of the patient described herein. The challenges presented by emerging or unusual presentations of surgical pathology secondary to HIV and AIDS in patients who are on anti-retroviral therapy provide an opportunity for research and the establishment of guidelines for the use of adjuvant chemotherapy in these patients.

A Case Report of Giant Genital Warts

“…HPV types 16, 18, 31 and 33 are often found in lesion with neoplastic transformation [6,7]. Occasionally types 16 and 18 are involved too [6,8]. Some authors consider poor hygiene and sexual promiscuity some risk factor for the disease.…”

Management of Giant Ano-Vulvar Condyloma in a Structure with Limited Resources

“…There were no pain, induration, or bleeding on contact and no lymphadenopathy at the inguino-crural ganglionic zones. The exploration of STI revealed a type I HIV infection with impaired immune status (the CD4 count was 200/mm 3 ). There were no other detectable STIs (syphilis) and the cervical cytology was normal.…”

Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

“…Flap components can be customized depending on the needs of the defect to include any or all of the following: skin paddle(s), fascia, and vastus lateralis muscle. The pedicled ALT flap though not as popular, has been used for the reconstruction of defects from mid-leg to the epigastrium (1)(2)(3)(4)(5). There is limited literature on the use of the ALT flap in black Africans (1)(2)(3).…”

“…The pedicled ALT flap though not as popular, has been used for the reconstruction of defects from mid-leg to the epigastrium (1)(2)(3)(4)(5). There is limited literature on the use of the ALT flap in black Africans (1)(2)(3). Its vascular anatomy, intra-individual, intra-and inter -racial variability in Caucasians and Asians have been widely reported (5).…”

“…However, considering the favorable profile of the ALT flap, the cost implications of vascular studies and other difficulties related to our clinical and social environment, we do not require vascular studies for our patient population. An internet search using the Google® search engine and PubMed for 'anterolateral thigh flap Africa, African, Kenya' and Bioline International and African Journals Online sites for 'anterolateral thigh flap' returned two papers (1,2). PubMed had one additional paper (9 …”