Giant condyloma of Buschke-Lowenstein (GCBL) is a rare, slow growing, wart-like, locally destructive tumor of the anogenital region. It is considered to be a verrucous carcinoma (a rare, well-differentiated variety of squamous cell carcinoma), but GCBL seldom metastasizes.

The cause of GCBL is not clear, although there has been association with human papillomavirus (HPV) types 6 and 11 and rarely types 16, 18, and 54. It is unknown which viral or host factors affect the oncogenic potential of the usually benign HPV strains and cause progression from condyloma acuminatum to GCBL, which behaves differently with relentless local invasion and tissue destruction.

Most cases of GCBL are in male individuals, with no racial predilection, although it can occur in women. In men, two-thirds of the lesions are seen before the age of 50. GCBL is rare. Most cases of GCBL are in male individuals, with no racial predilection. In men, two-thirds of the lesions are seen before the age of 50. GCBL is rare. Although verrucous carcinoma is most commonly found on the penis, sites involved can include the oral cavity, other anogenital regions, or plantar surface of the foot. If untreated, the growth may expand to or even start in the urethral, bladder, groin, perineal, and rectal areas.

The histology of GCBL is similar to that of a condyloma in that it is histologically benign, but different in that its downward growth pattern compresses and displaces normal tissue. Frank malignant changes have been associated in up to 56% of GCBL. The mortality of GCBL has been reported as 20%-30%, usually from complications due to pelvic invasion and rarely from metastases.

Common presenting symptoms at the early stages of the disease, which may last for years, are surprisingly benign; the slowly growing tumor does not cause noticeable discomfort. In the later invasive stage, there may be pelvic pain and discharge, bleeding, anemia, constipation, dysuria, hemorrhoids, difficulty in walking, weight loss, anorexia, and fatigue. Complications as the tumor progresses include fistulas, infection, blood loss, ureteral and urethral obstruction, anorectal stricture, rectal incontinence, and ileus.