Presentation of a Large and Debilitating Fungating Anogenital Lesion.

CASE REPORT:A 65-year-old Caucasian man presented with a debilitating anogenital lesion. DIFFERENTIAL DIAGNOSIS:The differential diagnosis of anogenital lesions includes infectious (syphilis, herpes simplex virus), noninfectious (hidradenitis suppuritiva, lymphedema), benign (condyloma acuminata), and malignant pathologies (squamous cell carcinoma, Kaposi sarcoma). DIAGNOSTIC ASSESSMENT, MANAGEMENT, AND OUTCOME:Biopsy of an anogenital lesion will determine any oncologic potential. Further imaging can better characterize the disease. Once in the operating room, oncologic principles should be adhered to and quality of life concerns prioritized. Reconstruction of large defects may require a multidisciplinary team. Genitourinary and gastrointestinal diversions should be considered to improve wound healing, decrease infection risk, and optimize graft take. DISCUSSION:A multidisciplinary approach to medical and surgical reconstruction of anogenital lesions should be considered for extensive malformations.