Human papilloma virus-16 causing giant condyloma acuminata
A 28-year-old multiparous lady, married at the age of 18 years and having 2 living children presented to the Gynaecology outpatient department with a growth in the vulva. The lesions started 6 months earlier as pin-sized papules in her labia majora and fourchette, associated with itching. They gradually increased in size and eventually coalesced to form large tufts. There was no history of coital dysfunction or postcoital bleeding. She had no menstrual complaints, neither did it interfere with her bladder and bowel function.\nHer husband was examined and found to be free of any gross lesions. The lady denied any history of extra-marital sexual contact or assault.\nExamination of the lesion revealed a 12 × 5 cm warty growth, with a cauliflower-like surface, arising from right and left labia majora and minora. Similar lesions were also present on the clitoris with additional satellite lesions scattered around the perineum, perianal region and lower vagina. Upper vagina and cervix appeared normal (Fig. ).\nA Papanicolaou cervical smear was performed which revealed no abnormality. Her HIV, HBsAg and VDRL status were negative. Her haemoglobin was 10.9 g%. A biopsy, under local anaesthesia, was performed (to rule out verrucous carcinoma) which was reported as condyloma acuminata.\nThe lady underwent a simple vulvectomy under spinal anaesthesia. Labia majora and most of labia minora were excised sparing the clitoris. Lesions on the perianal areas were also excised. Smaller lesions were cauterized. Wound was closed with 2-0 vicryl. Post-operatively, ice dressing was applied to the wound (Fig. ).\nThe post-operative period was uneventful and sutures were removed on 10th postoperative day.\nThe histopathological examination of the specimen was reported as condyloma acuminata with no evidence of malignancy. A PCR of the specimen revealed the presence of HPV-type 16 PGMY CHUV assay was performed on the sample to rule out mixed infection and the presence of only HPV-16 was confirmed [].\nFollow-up after 1 year did not reveal any new lesions.