Risk Factors of Giant Condyloma Acuminata in Immunocompetent Adult Woman

Abstract

Giant condyloma acuminata, or Bushke-Lowenstein tumor, is a rare clinical form of large anogenital warts that usually occur due to the patient's immunosuppressed condition. This case report aims to describe the risk factors of a rare case of giant condyloma acuminata in an immunocompetent patient. A 24-year-old female with lumps around her vagina and buttocks for two months. Initially, the mung bean size was enlarged and multiplied within one month. The patient had regular sexual intercourse with a single sexual partner for the past six months, and the last had sexual intercourse two months ago without using a condom. In the dermatovenereological status of the labia minora-vulva-labia majora-perineum-anus region, there are verrucous masses, multiple, well-defined, irregular edges, varied shapes and sizes, acetowhite test (+). The biopsy results showed a piece of papillomatosis-shaped tissue that appeared hyperkeratosis, showing images of corrosive cells with raisinoid nuclei that support condyloma acuminata. Based on anamnesis, physical examination, and supporting examinations, the patient was diagnosed with anogenital giant condyloma acuminata. The patient was then consulted with Digestive Surgery for a pro-wide excision treatment plan. The main risk factor for genital warts is having multiple sexual partners.
Meanwhile, immunosuppression is the main risk factor for developing giant condyloma acuminata. However, many other risk factors need to be considered and reviewed in immunocompetent patients, including genetic influences on HLA type, age, homosexuality, prostitution, chronic genital infection or irritation, poor hygiene, smoking, history of other sexually transmitted infections, simultaneous infection with another type of HPV, also pregnancy and hormonal contraception. The risk of Giant condyloma acuminata cases occurring in immunocompetent patients needs to be reviewed for other risk factors that may be present in the patient or their sexual partner, especially considering the high recurrence rate.