|Year : 2004 | Volume
| Issue : 2 | Page : 175-176
Case report: Penile horn overlying condylomata acuminata
Vivek Singla, Rohit Ajmera, BL Laddha
Department of General Surgery and Urology, JLN Medical College, Ajmer, India
House No.90 Sector-8, Panchkula- 134 109
Source of Support: None, Conflict of Interest: None
Keywords: Penile horn, Condylomata acuuninata.
|How to cite this article:|
Singla V, Ajmera R, Laddha B L. Case report: Penile horn overlying condylomata acuminata. Indian J Urol 2004;20:175-6
| Case Report|| |
A 30-year-old married Hindu male presented with a 3 months history of a horn-like growth over the penis. His only significant medical history was a circumcision for warty swellings over the prepuce about one year back, which on histopathologic evaluation revealed Condylomata acuminata. He denited a history of sexual exposure. There is no similar or related condition in any of his family members.
Physical examination revealed a circumcised penis showing a nontender, 4 cm long, curved, horn-like lesion projecting at 12 O'clock position, a small, 2 cm long lesion at 10 O'clock and a 1 cm long lesion at 2 O'clock position over the corona glandularis [Figure - 1]. There was no erythema or induration at the base and there is no inguinal lymphadenopathy. He did not have verrucae anywhere else over the body. His systemic examination was unremarkable. All the routine investigations were normal including non-reactive VDRL and negative HIV tests.
A clinical diagnosis of penile cutaneous horn was made and surgical excision of the growth with a 5 mm normal margin of the glandular tissue around the base was performed.
Histopathological examination of the growth revealed hyperkeratosis, parakeratosis acanthosis and clear vacuolization of prickle cells (koilocytosis) [Figure - 2], features suggestive of Condylomata acuminata.
| Comments|| |
Cutaneous horns are distinguished from other keratotic lesions clinically by presence of roughly conical keratotic mass. The important issue is not the horn itself, which is dead keratin, but rather the nature of the underlying condition. Although the lesions underlying a cutaneous horn are usually benign, i.e., wart, naevi, trauma, burn, Lupus vulgaris, malignant conditions like squamous cell carcinoma, basal cell carcinoma, granular cell tumour, sebaceous carcinoma, Kaposi's sarcoma, metastatic renal cell carcinoma, may also co-exist. 
Condyloma acuminata, a benign condition, commonly occurs over penis, vulva in and around the anal canal, scrotum, vagina, urethra. Cutaneous horns overlying Condyloma acuminata are rare and multiple horns are very rare. Papillomatosis, hyperkeratosis, parakeratosis, acanthosis and intact basement membrane with no invasion of underlying stroma are histopathological features of Condyloma acuminata.
Local application of podophyllin, trichloroacetic acid, 5-fluorouracil cream, cryosurgery, excision using diatheramy or laser (Nd:YAG, KTP, CO 2 ) and ultrasonic destruction are current therapies of Condyloma acuminata. Interferons are reserved for extensive and recalcitrant lesions.  Cutaneous horn of penis is treated by surgical excision due to its possible association with malignant lesion.  Careful evaluation of the base and close follow up for any recurrence of lesion is essential.
| References|| |
|1.||Thappa DM, Garg BR. Thadeus J, Ratnakar C. Cutaneous horn: A brief review and report of a case. J Dermatol 1997; 24: 34-7. |
|2.||Lynch DF, Pettaway CA. Tumours of the penis. In: Campbell's Urology, 8 th edition. Saunder's Publications, 2002; pp 2946-2948. |
|3.||de la Pena Zarzuelo E, Carro Rubias C, Sierra E, Dal-ado JA, Silmi Moyano A, Reset Esteves L. Cutaneous horn of the penis. Arch Esp Urol 2001: 54: 367-8. |
[Figure - 1], [Figure - 2]