Rapidly Progressive Perianal Giant Condyloma in an Immunocompetent Adolescent: An Unusual Abuse-Associated Case

Buschke-Löwenstein tumor (BLT) is a rare, locally aggressive variant of condyloma acuminata associated predominantly with HPV genotypes 6 and 11. It presents as a progressively enlarging, exophytic, verrucous mass in the anogenital region with infiltrative growth and potential for significant local destruction. Predisposing factors include diabetes mellitus, tobacco and alcohol use, pregnancy, chemotherapy, and immunosuppression; however, cases in immunocompetent individuals have been reported. A 15-year-old female presented with an 8.5 cm perianal verrucous mass. She had no comorbidities or conventional risk factors but reported sexual assault 1.5 years earlier. Histopathology confirmed giant condyloma acuminata, and PCR genotyping identified HPV type 11. Laboratory findings, including HIV serology, were unremarkable. Complete surgical excision was performed without complications. At the one-month follow-up after the excision procedure, all lesions had disappeared, and no new lesions had appeared. This case highlights the unusual occurrence of BLT in an immunocompetent adolescent after sexual assault and emphasizes the importance of early recognition, consideration of underlying abuse, and timely management to prevent disease progression.