CUTANEOUS HAMARTOMA LIKE GIANT CONDILOMA IN PUBIAN REGION

Condyloma, caused by Human Papilloma Virus (HPV), is a sexually disease transmitted and in the pubic region is very common. We report the case of an 18-year-old female patient who was referred to the Gynecological Oncology referral hospital for clinical suspicion of giant condyloma in the pubic region. This lesion started seven months before the consultation and grew rapidly. As a medical history, healthy patient, without continuous medication and history of keloids in previous scars. As an obstetric antecedent, she had a pregnancy with fetal death due to alleged thrombophilia. The lesion was midline in the pubic region, measuring approximately 10 cm and with clinical features of giant condyloma. Resection of the lesion and reconstruction with lobulated flap and closure suture in two planes were performed. Pathologically, it resulted from a benign mesenchymal lesion characterized by proliferation of connective tissue with thick collagen fibers in the middle and absence of significant atypia with mitotic index from 0 to 1 mitosis in 10 cga, with no necrosis and typical overlying epidermis, without evidence viral cytopathic effect and free resection margins. In immunohistochemistry, a mesenchymal lesion was found showing nuclear positivity for beta-catenin in storiform areas, with positivity for smooth muscle markers in muscle fiber bundles and S-100 protein in typical mature adipocytes. The morphological pattern associated with immunohistochemical study favors the diagnosis of cutaneous Hamartoma or Fibromatosis, due to areas of nuclear positivity for beta-catenin, with no malignancy criteria. The postoperative period was considered optimal and adhesive gel slides were used as a prophylactic measure of new keloid without the need for local corticosteroid injection.

Publication History

Article published online:
23 October 2019