Introduction. The Buschke — Loewenstein tumour was described for the first time in 1925 as a rare giant condyloma. The main cause of this pathology is the human papillomavirus, which is introduced into the body under certain conditions. This pathogen can be transmitted sexually. The neoplasm is usually localised in the anogenital region. Malignant transformation and its spread to the penis are even more rare.Aims. The Buschke — Loewenstein tumour is a rare pathology, whose course and treatment features are of considerable interest to urologists.Materials and methods. This article presents a clinical case of the malignant giant Buschke — Loewenstein tumour with primary localisation on the anterior abdominal wall and spreading to the genitals of a 42-year-old man without accompanying immunodeficiency or urogenital infections. The anamnesis of the gradually progressive disease in the absence of any treatment was more than 10 years. When preoperative cytological examination of the biopsy did not reveal signs of malignant transformation, the patient underwent simultaneous removal of all neoplasm foci and reconstructive plastic surgery using skin grafts.Results and Discussion. The foci of the tumour were removed entirely without disturbing surgical boundaries. A postoperative histological examination revealed small foci of squamous cell carcinoma in remote tissues. A postoperative observation conducted six months following surgery revealed no signs of recurrence of the disease.Conclusion. Buschke-Loewenstein tumours are rarely accompanied by malignancy. Nevertheless, oncological vigilance forms a necessary element of postoperative procedures. Following removal of a large neoplasm, the choice of reconstructive plastic surgery is of particular significance for postoperative quality of life. For the prevention of relapse, it is advisable to conduct immunotherapy in the postoperative period.