Combined approach for the treatment of anorectal condyloma. Carbon dioxide laser excision and endoscopic argon plasma coagulation in a case report.

Condyloma acuminatum (CA) is a sexually transmitted disease caused by human papilloma virus (HPV). Infection with HPV is a major risk factor for development of anal squamous cell carcinoma. In clinical practice, it is frequently limited to the perianal skin or anal canal and it is rarely described a rectal mucosal extension. Several therapeutic options are developed for CA, including chemical or physical destruction, immunological therapy, or a surgical excision. However, these treatments still have some degree of limitations and important side effects compromising patient compliance and reducing treatment efficacy. CO2-laser emits a continuous beam, absorbed by biologic tissues, that vaporizing intracellular water, destroys target lesions. Argon plasma coagulator (APC) is a non-contact method of endoscopically delivered high-frequency thermal coagulation allowing well-controlled superficial tissue destruction. We present a case of a young female affected by anorectal condiloma extended to rectum, that was successfully treated with combined ginecological (carbon dioxide laser) and endoscopic approach (argon plasma coagulator), with no side effects during the follow up and complete remission after two applications.