A 55-year-old uncircumcised man presents with a large, slowly enlarging cauliflower-like mass of the penis measuring 7 cm, present for two years. Biopsy shows exophytic acanthosis, papillomatosis and koilocytosis without cellular atypia. Which statement is correct?

• A It is caused by Treponema pallidum and will respond to benzathine penicillin
• B It is caused by HPV type 16 and carries a high rate of metastasis to inguinal nodes
• C It is a well-differentiated squamous cell carcinoma requiring immediate penectomy
• D It is caused by HPV types 6 and 11 and behaves as a locally destructive but histologically benign tumour ✓

Explanation

Giant condyloma acuminatum (Buschke-Lowenstein tumour) is caused by low-risk HPV types 6 and 11. Although histologically benign with koilocytosis and no atypia, it grows destructively, infiltrating and fistulising local tissue, and requires wide surgical excision. High-risk HPV 16 drives invasive penile SCC with metastatic potential, and syphilitic chancre is an ulcerated indurated lesion responding to penicillin, both excluded by the benign biopsy.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.