Squamous cell carcinoma in situ in condyloma acuminatum.

This is the 14th case report of squamous cell carcinoma in situ developing in perianal condyloma acuminata. A 72-year-old nonhomosexual man suffered this lesion 11 months after his condyloma was first fulgurated. The lesion was excised locally. He received no local or systemic chemotherapy. Random biopsies on several occasions since that time have not shown any evidence of local recurrence. Squamous-cell carcinoma in situ in perianal condyloma must be distinguished from Bowen's disease and extramammary Paget's disease of the perianal skin, both of which have associated skin rashes. Although Bowen's disease and extramammary Paget's disease frequently are associated with either local or distant malignancies, no such association has been found for squamous cell carcinoma in situ in condyloma unless the patient also has the acquired immunodeficiency syndrome (AIDS). Since this lesion is a premalignant lesion like Bowen's disease and extramammary Paget's disease, squamous cell carcinoma in situ in condyloma is treated by local excision. If the margins are free of tumor, the resection is curative. No local or systemic recurrence of this condition has been reported following adequate local resection. Patients with condyloma acuminata should undergo treatment to eliminate all of the warts. When the condylomata recur, or when the patient has AIDS, the lesions should be examined histologically for evidence of premalignant or malignant degeneration.