PMC4724757_01
A) Preoperative aspect of the lesion (16 x 12 cm). B) Preoperative MRI: Suspect infiltration.
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F1
At time of presentation in our clinic the size of the condylomata acuminata amounted 16 x 12 cm (Figure 1A (Fig. 1)). The MRI revealed a possible infiltration of the musculus ani externus (Figure 1B (Fig. 1)).
A) Situation prior the en bloc resection of the condylomata acuminate. The mucosa of the musculus sphincter ani externus is armed by sutures. B) Specimen after resection.
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F2
Subsequently, the giant condylomata acuminata tumor was resected in toto including the resection of the external parts of the musculus sphincter ani externus (Figure 2 (Fig. 2)).
After resection, the mucosa of the musculus ani externus was fixed by circular sutures into the edge of the skin.
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F3
The mucosa of the anus was fixed by circular sutures (Figure 3 (Fig. 3)).
The large skin defect was closed by two gluteus flap.
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F4
Finally, the mucosa of the anus was adapted to the skin of the gluteus flaps (Figure 4 (Fig. 4)).
Postoperative result 6 months after the resection. The patient had a normal sphincter function. Aspect of the perianal region in prone position.
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F5
Fortunately, the patient did not experience any defecations problems and did not develop recurrence of condylomata acuminata up to date (Figure 5 (Fig. 5)).