Delayed Presentation of Giant Condyloma Acuminatum: A Case Report

Buschke-Löwenstein tumor (BLT), or giant condyloma acuminatum, is a rare, slow-growing, locally invasive tumor associated with human papillomavirus (HPV). Although histologically benign, it demonstrates aggressive local growth, high recurrence rates, and potential for significant morbidity, necessitating timely diagnosis and surgical management. Risk factors include chronic HPV infection, immunosuppression, poor hygiene, and limited access to healthcare. We report a 47-year-old man with a 15-year history of a progressively enlarging perianal mass, with delayed presentation due to embarrassment and financial barriers. The lesion extended circumferentially to the bilateral groin, scrotal, and perineal regions, with groin lesions measuring 12 × 6 × 6 cm on the left and 12 × 3 × 3 cm on the right, causing pain, malodor, and impaired mobility. Biopsy confirmed condyloma acuminatum without malignant transformation, with low-risk HPV positivity and wild-type p53 expression. The patient underwent staged surgical excision with multidisciplinary support, including social and financial services. This case highlights the impact of social and economic barriers on delayed care, allowing otherwise manageable HPV-related lesions to progress to advanced disease. Early recognition and improved access to care are essential to prevent severe morbidity associated with BLT.