Giant condylomata accuminata (CA) is a pre-malignant tumour, which commonly involves the genital area. Human papilloma virus (HPV) 6 and 11 are the most common causative pathogens for this rapidly growing tumour. (CA) has been also associated with human immunodeficiency virus (HIV) infection, 40 to 60 per cent of benign (CA) transforms to malignancy. The main risk factors for HPV infection and subsequently condylomata include risky sexual behaviours, early pregnancy and tobacco use.

Here, we report a 55-year-old man who presented with complicated giant perianal (CA) that transformed into squamous cell carcinoma. His condition was complicated by recurrent infections and massive bleeding. The patient underwent end colostomy followed by surgical resection of the mass followed by palliative radiotherapy. Histopathological analysis of the resected mass confirmed transformation into squamous cell carcinoma. Malignant transformation of (CA) should be suspected in patients with rapidly enlarging perianal mass and progressively invasive disease.