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CASE REPORT
Year : 2004  |  Volume : 20  |  Issue : 2  |  Page : 175-176
 

Case report: Penile horn overlying condylomata acuminata


Department of General Surgery and Urology, JLN Medical College, Ajmer, India

Correspondence Address:
Vivek Singla
House No.90 Sector-8, Panchkula- 134 109
India
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Source of Support: None, Conflict of Interest: None


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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

How to cite this URL:
Singla V, Ajmera R, Laddha B L. Case report: Penile horn overlying condylomata acuminata. Indian J Urol [serial online] 2004 [cited 2019 Jun 18];20:175-6. Available from: http://www.indianjurol.com/text.asp?2004/20/2/175/20754



   Case Report Top


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 Top


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. [1]

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. [2] Cutaneous horn of penis is treated by surgical ex­cision due to its possible association with malignant lesion. [3] Careful evaluation of the base and close follow up for any recurrence of lesion is essential.

 
   References Top

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.  Back to cited text no. 1    
2.Lynch DF, Pettaway CA. Tumours of the penis. In: Campbell's Urol­ogy, 8 th edition. Saunder's Publications, 2002; pp 2946-2948.  Back to cited text no. 2    
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.  Back to cited text no. 3    


    Figures

  [Figure - 1], [Figure - 2]



 

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