For all the non-medical readers, the title is not something I made up just to arouse your curiosity. Unfortunately, we had a patient of middle east descent recently who presented to us with a large growth in his perineal area (close to the anus).
He had been harbouring it for 10 years. When it started it was about the size of a pea. At present it was about the size of a soccer ball. This is the actual photo. No kidding! What must have started at the anal region as a simple wart was now extending upto the anal cleft behind and the groin in front! What provoked the man to keep it in hiding for all this time eludes even his brain. Somewhere in this mass was his anal opening. Can you even imagine the logistics of hygiene!
Well, we had the honour of having to operate on it and excise what we could while trying to save his sphincter functions. No sooner had we started that we realised that this most likely has undergone malignant change (become cancerous). Every portion we touched would bleed like crazy. The condyloma had become so vascular that it was very like that it had progressed to squamous cell carcinoma as is bound to happen after such a long period of having it. We excised what we could and tried to suture his skin back in place while sending the specimen for histopathological examination.
As it turned out, it was squamous cell carcinoma but the margins could not be identified, meaning we didn't know if we got all of it or was some element left in situ. We asked him to go for an Oncologists opinion for radiotherapy.
He refused! He still is resistant to go there and is thinking of going back to his home country.
God help him!