Giant condyloma acuminatum of the perianal region: a case of complete eradication with zinc oxide starch powder

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  • Kaiami Hitomi
    Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine
  • Hirata Chika
    Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine
  • Tsuruta Daisuke
    Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine

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  • 亜鉛華デンプンで消退した肛門部巨大尖圭コンジローマの1例
  • アエンカ デンプン デ ショウタイシタ コウモンブ キョダイ セン ケイ コンジローマ ノ 1レイ

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Abstract

A 55-year-old woman had been experiencing an itchy sensation in the vulva for two years prior to the initial visit, and a mass had been observed in the vulva and perianal area for two months. The patient was referred to our department after topical imiquimod failed to improve the lesion. From the vulva to the perianal area, a grayish-white mass, 9.5 cm × 3 cm in size, with a chicken-crown-shaped elevation was observed. Histopathologically, the epidermis was thickened in an externally directed, papillomatous shape with hyperkeratosis. There was parakeratosis and koilocytosis of keratinocytes in the epidermis. No findings suggestive of malignancy were found. Based on the clinical and histopathological findings, a diagnosis of giant condyloma acuminatum (GCA) was made. The patient was treated with topical zinc oxide starch powder to reduce the size of the mass. Surprisingly, the masses disappeared in two months. We have not confirmed whether GCA has recurred since the patient stopped coming to our hospital. GCA is defined as a cauliflower-shaped tumor that appears malignant but is histopathologically benign. Although surgical resection is considered the most reliable treatment, recurrence rates are as high as 50% even after surgical resection. In 2010, two cases of GCA were reported in which treatment with zinc oxide starch powder was effective. If the tumor is large and is treated as it is, the resulting skin defect will also be large and healing will take time. The application of topical zinc oxide starch powder to the tumor may reduce its size, or there might be complete regression of the mass.

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