Condyloma acuminata: a fatal disease?

Condyloma acuminata is a virally mediated epithelial overgrowth caused by the human papilloma virus. Its simplest form is the common wart, which may occur almost anywhere on the body surface. Its papillary lesion forms are commonly seen in the genital, perineal, and anal areas, though it also infects the conjunctiva, nose, mouth, larynx, and tracheo-bronchial tree. Malignant degeneration may occur in any of these areas. Diagnosis is established by clinical impression and biopsy. Immunoassay methods exist but are simply indicative of the presence of infection and are not useful in predicting the course of the disease. Many treatment modalities exist and all work well for minor lesions. For large lesions such as the giant condyloma acuminata, also known as the Buschke-Lowenstein lesion, only radical surgical extirpation is considered to be appropriate treatment. This case report, as well as others referenced in this study, documents the extreme complexity of management of many of these lesions and the fatal outcome of this disease process in a significant number of cases.