Gigantean condyloma A63.0

Infiltrating giant form of the condyloma acuminata with perforation in the urethra or fenestration of the prepuce.

Some authors consider condylomata gigantea to be a group of verrucous carcinomas (see carcinoma verrucous).

m:w=2.4:1

Long-term (usually >10 years) persistent HPV infection (see below papilloma viruses , human) with transition to a verrucous carcinoma. Detection of papillomaviruses, especially the low-risk types HPV 6, HPV 11, HPV 56. 1x coinfection with the highly malignant alpha-mucosotropic HPV type 52 could be described (see below papillomaviruses, human). Coinfection with HIV is often detectable (up to 14% of patients - cited by Sporkert M 2017).

Mainly occurring in male adults. Age of first manifestation: 20-40 years (median age at first diagnosis = 46.5 years - Sporkert M et al. 2017)).

S.u. Carcinoma verrucous.

Organ-preserving surgical removal in healthy people. In very extensive cases and in case of localisation in the penis area, a penis amputation may be necessary.

Notice! Condylomata gigantea should always be histologically controlled! Focal invasion and recurrences are seen after surgery in up to 50% of cases! However, metastases are very rare!

Alternative: In special cases (e.g. inoperability at high age) a combination therapy with 5% Imiquimod ointment and CO ₂ laser can be chosen: period 6 weeks; 3 times/week Imiquimod for 12 hours, then wash off, then laser ablation with_{CO2 laser} and again therapy with Imiquimod for another 6 weeks.

Alternative: In individual cases a very good response to neoadjuvant or monotherapeutic radiochemotherapy (54Gy, Mitomycin-5-FU or Cispatin+5-FU) was reported.

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