Giant Condyloma of Buschke-Lowenstein: An Atypical Case

Joseph K. Kim, MD; Gabriel S. Levi, MD; David L. Carr-Locke, MD

Disclosures

January 05, 2012

Abstract

A giant condyloma was identified in a young man with a history of HIV (CD4 count 300) who initially presented to the emergency department with painless rectal bleeding with clots for 36 hours. He described the episodes as intermittent and the bleeding as large in volume. The patient was evaluated in the emergency department by surgery who then consulted gastroenterology. Rectal examination revealed a firm and mobile mass that was palpated in the rectum. Expedited flexible sigmoidoscopy revealed a large circumferential polypoid mass. Biopsy determined that the mass was a giant condyloma acuminatum. Meanwhile, MRI of the abdomen and pelvis was read as a large rectal cancer penetrating through the mesorectal fascia along with enlarged mesorectal lymph nodes. The patient continued to have episodes of voluminous bleeding; therefore, he was taken to the operating room for an excision of the mass. Postoperatively, the patient requested to return to Taiwan for the remainder of his evaluation and treatment.

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