Giant anogenital condyloma acuminata with extragenital involvement in an immunocompetent host

Condyloma acuminata is an uncommon epithelial proliferative and infiltrative growth associated with human papillomavirus (HPV) subtypes 6 and 11. Giant condyloma acuminata is a more aggressive variant characterised by extensive growth, anatomical disfigurement, psychosocial morbidity and a high recurrence rate. Extragenital involvement in an immunocompetent individual is uncommonly reported in the literature. We report a case of an immunocompetent young woman who developed a rapidly progressive verrucous growth involving the vulva, lower vagina, perianal region and also extragenital sites (inframammary fold and axilla). Pelvic MRI demonstrated a large exophytic lesion without underlying stromal involvement. Complete surgical excision with histopathological confirmation demonstrated condyloma acuminata with low-risk HPV type 11. Early recurrence occurred within 3 months, which was managed by topical medication. This case highlights the importance of clinical examination, the role of MRI followed by surgical excision with long-term follow-up even in immunocompetent patients.