罕見的陰莖巨大尖銳濕疣伴隨包皮自發性穿孔：病例報告

鄭苑伶¹、許富傑²、曹智惟¹、蒙恩¹、于大雄¹

三軍總醫院泌尿外科部¹；三軍總醫院 外科部 大腸直腸外科²

An atypical case of penile giant condyloma acuminatum with spontaneous perforation of the prepuce: A case report

Yuan-Ling Cheng¹, Fu-Chieh Hsu², Chih-Wei Tsao¹, En Meng¹, Dah-Shyong Yu¹

Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan¹; Division of Colon and Rectal Surgery, Department of Surgery, Tri‐Service General Hospital, National Defense Medical Center, Taipei, Taiwan²

Background: Giant condyloma acuminatum (GCA) is a rare condition characterized by a slowly growing tumor that affects the anogenital area.

Case report: We report the case of an 88-year-old male with a 5-year history of progressively enlarging, cauliflower-like warts on the penile shaft, pubic region, and groin, along with urine leakage along the distal penile shaft. Physical examination revealed an ulcerative skin perforation with pus discharge beneath the distal prepuce, initially suspected to be a urethral fistula. However, during surgery, it was found that the perforation was due to a giant condyloma lesion that had blocked the prepuce opening, with infection and high pressure causing skin rupture. The patient underwent circumcision and wide excision of the warts using electrocautery. He was discharged postoperatively, with residual lesions managed using imiquimod and low-dose oral tegafur-uracil.

Conclusions: Penile GCA can lead to prepuce perforation and may be managed postoperatively with imiquimod and low-dose oral tegafur-uracil.