Condyloma, is a sexually transmitted infection caused by certain strains of the human papillomavirus (HPV). The appearance of condyloma may be small, raised, flesh-colored or grayish bumps. They may be singular or clustered and often have a cauliflower-like texture due to their irregular, bumpy surface. The lesions are usually soft and can be smooth or slightly rough. In contrast with condyloma, the appearance of penile squamous cell carcinioma (Scc) usually presents as a firm, indurated mass that may have irregular borders. The surface can appear raised, with areas of crusting or necrotic appearance. However, sometimes it’s hard to distinguish between condyloma and penile SCC based on appearance, thus, additional biopsy is necessary for diagnosis.

This is a 39-year-old male patient who came to the clinic due to genital abnormalities. PE showed extensive firm, raised, rough and scaly surface over glans and prepuce. At this point, there is a suspicion that this may be penile cancer. However, the pathology report revealed it is condyloma acuminate. Therefore, circumcision and electrocautery were performed and the final pathology reports still indicates it’s condyloma acuminate.

One month after surgery, some local residual genital warts were found and after receiving electrocautery, the patient's prognosis was relative stable, no more recurrence has been observed in recent 1 year.

This case demonstrates how clinical appearances can sometimes be deceptive in the diagnosis of genital conditions. The patient initially presented with a penile lesion that raised concerns for penile cancer. However, the pathology report contradicted these initial suspicions . This emphasizes the variability in how different diseases can present and highlights the need for careful evaluation, as many conditions can share similar clinical characteristics. Although the lesion initially seemed concerning, the accurate diagnosis of genital warts enabled the administration of the proper treatment.