[Condylomata acuminata gigantea. Surgical and combined immunomodulatory therapy].

A 50-year-old female developed extensive condylomata acuminata in the genitoanal region over a period of 12 years. She presented with multiple, verrucous lesions involving the whole genitoanal area plus the adjacent perineum and gluteal region which made it impossible to identify the anatomical structures. Proctoscopy was normal. Serology for infectious diseases was negative. Several biopsies showed no signs of malignant transformation. Tumor excision under general anaesthesia was incomplete. Therefore, adjunctive therapy with immunomodulatory agents was administered, utilizing local application of imiquimod cream (3 x weekly) for 3 months and subcutaneous injections of interferon-alpha-2a (3 million IU 3 x weekly) for 5 months. This treatment regimen resulted in complete remission of all skin lesions with only discrete superficial scarring but no significant loss of anatomical structures or functions. During a 1-year follow-up the patient showed no sign of relapse.