Buschke Lowenstein tumour (BLT), also known as giant condylomata acuminate is a rare locally invasive tumour. This cauliflower-like lesion of the anogenital region often arises from a pre-existing warty lesion. It is locally destructive despite a relatively benign appearance on histopathology. It carries a high recurrence rate and a significant potential for malignant transformation into verrucous squamous cell carcinoma. While wide surgical excision has been the mainstay of therapy, use of combination treatments is gaining ground. However, patient-specific issues and complications often render ideal treatment infeasible, with need for innovative approach to therapy. We report the case of a young Indian man with BLT with dysplastic changes, treated successfully with 16-week long monotherapy with 5% imiquimod cream, owing to unsuitability of traditional therapies in his case.

Keywords: Buschke Lowenstein; Genital Wart; Condylomata Lata; Squamous Cell Carcinoma; Imiquimod.