Condyloma acuminatum is a benign disease caused by Human Papillomavirus that is sexually transmitted and that can cause malignant transformation. In HPV transmission homosexuality, bad genital hygiene, chronic genital infections, and polygamy can be considered as risk factors. BLT is a rarely seen form which develops by the overgrowth of condyloma acuminatum and has a high risk of malignant transformation [4
]. BLT is considered pathologically to be in between condyloma acuminatum and perianal squamous cell carcinoma. Although squamous cell carcinoma in perianal region is clinically similar to condyloma acuminatum and giant condyloma acuminatum, in histopathological examination squamous cell carcinoma differs from the other two with regard to malignant proliferation. However, BLT shows similarity to malignity with deep invasion to the tissue below, fast mitotic activity, and proliferation. Most commonly seen clinical symptoms are pelvic pain, perianal secretion, anorectal bleeding, and the impairment of anal sphincter continence. BLT's local recurrence rate is high. Malignant transformation occurs in approximately 30–50% of the patients. Chronic alcoholism, immune suppressing medicine, and diseases increase the recurrence and malignant transformation risk.
Most efficient treatment method especially during the early period of disease is a surgical excision [5
]. Systemic or topical chemotherapy and radiotherapy can be applied to patients to whom surgical operation cannot be performed. This method is mostly considered in irresectable cases for palliative treatment after incomplete excision and in recurrent cases [6
]. In cases where rectum and anal sphincter muscles are invaded, recurrence or malignant transformation is developed, there are various treatment options as abdominoperineal resection. Most of the authorities suggest a temporary loop colostomy to be opened to prevent fecal contamination in the wound before wide surgical excision [7
]. Since our case presented only anal mucosa involvement and malign transformation was not detected, wide local excision was chosen. Laparoscopic loop sigmoidostomy was performed that is frequently used nowadays to prevent fecal contamination. Since malign transformation was not observed in the histopathology of excised piece, chemoradiotherapy or any other new surgical invasion was not planned for the patient after surgery.