Excision of giant condyloma and V–Y flap reconstruction

Excerpt

A 22-year-old heterosexual male presented with a 24-month history of perianal mass (Fig. 1). Biopsy of the skin margin demonstrated giant condyloma with suspected malignant transformation. On examination under anesthesia, the growth did not reach the dentate line (Fig. 2). The mass was excised with tumor-free margins (Fig. 3). Two V-shaped wedges of skin were advanced from each buttock and anastomosed to the anal canal with interrupted 0 Vicryl sutures (Ethicon Inc.) (Fig. 4). Suction drains were left in place (Fig. 5). The patient remained prone for 3 days. Intravenous antibiotics (metronidazole–ceftazidime) were started 1 h before surgery and continued for 7 days. The patient was kept on a liquid diet for 4 days and on loperamide 8 mg daily for 14 days to minimize fecal passage. Drains were removed after 6 days. The wound was completely healed by 4 weeks (Fig. 6). The definitive histology confirmed a giant condyloma without malignant transformation. The patient was asymptomatic and tumor-free at 26-month follow-up.

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