Giant condyloma acuminatum (GCA) is a slow-growing, large, cauliflower-like
tumor located in the anogenital region. This
tumor has a locally destructive behavior, a high recurrence rate and occasional transformation to
squamous cell carcinoma. Risk factors include anoreceptive intercourse, HIV and immunosuppression. There is no general agreement on the choice of treatment for this
tumor. Wide radical excision with
plastic reconstruction of skin defects seems to be the best treatment, while adjuvant
therapies, such as
radiotherapy and
immunotherapy, may achieve good results, but their effectiveness is still uncertain. Loop
colostomy, considered mandatory by several authors in order to minimize
wound contamination risk, does not appear to be necessary (except in cases of anal canal involvement beyond the dentate line) if a combination of bowel cleansing, non-fiber diet and
loperamide can be administered. The authors report 3 cases of perianal GCA treated by radical local excision and reconstruction by S-plasty grafts, without performing loop
colostomy