Condylomata acuminata, giant condyloma acuminatum buschkeloewenstein tumour and verrucous squamous carcinoma of the perianal and anorectal region. It rarely occurs in the floor of the mouth and tongue. Histopathology revealed a hyperplastic stratified squamous epithelium with upward extension of verrucous projections, which. Archives of the department were retrieved for verrucous lesions. Carcinoma cuniculatum verrucous carcinoma of the skin. One histologic feature, important for the diagnosis, is the absence of cellular atypia. It appears as a single warty, discolored growth in the affected area, most commonly the sole of the foot, though it can appear anywhere on the body, including on the genitals or in the mouth. The challenging diagnosis of verrucous carcinoma of the auricle. During surgery, doctors will remove the entire tumor and a bit of the surrounding tissue. They are generally considered as slow growing tumors with good prognosis.
Verrucous carcinoma verrucuous carcinoma is an uncommon kind of welldifferentiated squamous cell carcinoma. Owing to its bland cytology, it is a challenging diagnosis. It is a slow growing tumor, which presents predominantly as an exophytic growth with a pebbly, micronodular surface and tends to spread locally. Histopathology of vc lacks signs of epithelial dysplasia. To our knowledge, only nine cases of verrucous carcinoma of the temporal bone have been reported in the english literature. Verrucous carcinoma of the leg a rare variant of squamous. Not a common tumor verrucous carcinoma was first described in 1948 in the oral cavity surgery 1948. Verrucous carcinoma vc is a variant of well differentiated squamous cell carcinoma with low malignant potential.
Verrucous carcinoma of the foot with bone invasion. In our department he underwent an aggressive and accurate debridement with. Verrucous carcinoma is a relatively uncommon, locally aggressive, clinically exophytic, lowgrade, slowgrowing, welldifferentiated squamous cell carcinoma with minimal metastatic potential. Treatment options for verrucous carcinoma may depend on the location of the tumor, but they usually begin with surgery. After thorough histopathologic examination, 10 cases were confirmed as vc. The survival rates are observed to be the highest among women with verrucous carcinomas. Endoscopic examination revealed an irregular protruding circumferential erosion in the lower thoracic esophagus, but because pathological examination of the biopsy specimen showed no evidence of malignancy, the status of the erosion was followed up by an upper. What are the treatment options for verrucous carcinoma. A 50 yearold man was presented with complaining of oral discomfort. It was first described by ackerman in 1948, and is associated with both lowrisk types 6 and 11 and highrisk types 16 and 18 types of hpv 47. Verrucous carcinoma vc is a locally invasive, nonmetastasising well differentiated variant of squamous cell carcinoma.
Introduction oral verrucous carcinoma is a rare tumor first described by ackerman. The effects of resin of podophyllin on condyloma acuminatum. Verrucous carcinoma is a type of squamous cell carcinoma that may be associated with hpv infection may be subtypes 16 or 18, but types 6 and 11 have also been reported, as have hpv negative variants. Verrucous carcinoma causes, symptoms, treatment, prognosis. A classical verrucous carcinoma, with an exoendophytic growth pattern and a pushing invasive front is easily identi. Welcome to the updated version of pathology for urologists. Squamous cell carcinoma scc stems from keratinocytes.
Verrucous carcinoma of the tongue a rare case study. Pdf ackermans tumour commonly known as verrucous carcinoma vc is a low grade variant of oral squamous cell carcinoma oscc. Verrucous carcinoma ackermans tumor is a low grade variant of oral squamous cell carcinoma oscc. The late or advanced stages of pvl cannot be differentiated clinically from verrucous carcinoma or an exophytic papillary form of squamous cell carcinoma. Jan 08, 2019 verrucous carcinoma of vagina is a rare histological variant of vaginal squamous cell carcinoma. Outcomesresolutions in general, verrucous carcinoma of vagina has the best prognosis on a stagetostage comparison with respect to all other histological subtypes of vaginal squamous cell carcinomas. Oral verrucous hyperplasia versus oral verrucous carcinoma. A 74yearold man presented with a foot lesion that had been diagnosed as a skin infection 7 years earlier. The incidence of vc of the oral cavity is between 2% and 16% of all oral cancers.
As a lowgrade and welldifferentiated verrucous variant of oscc, oral verrucous carcinoma ovc accounts for 212% of all oral carcinomas with a 5year. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia or sole of the foot. The demographics, clinical presentation, and surgical outcomes of vc are believed to be different from oscc. It is very rare in the urinary bladder and mostly associated with schistosomiasis. Epithelial dysplasia in the mucosa was recognized in the vicinity of vc in. Verrucous carcinoma vc of the nail bed and matrix is a rare malignancy that is often misdiagnosed as a benign condition. Verrucous carcinoma of the anus surgical pathology criteria. We present a case of a 65yearold woman with a 2year history of a progressive right fourth fingernail verrucous plaque replacing and surrounding her entire fourth fingernail. Our clinical differential diagnosis included verrucous carcinoma and hypertrophic variety of lupus vulgaris. Verrucous squamous cell carcinoma scc of skin is a malignant tumor of skin that typically affects elderly men and women. Printable verrucous carcinoma of the anus surgical.
Verrucous carcinoma vc is a rare oral tumor that is classified under carcinomas owing to characteristics that exists amid a benign verrucous lesion and malignant squamous cell carcinoma scc. Ackermann first described this neoplasm of the oral mucous membrane, which is now also know as verrucous carcinoma of ackermann or ackermanns tumor. The most common sites of verrucous carcinoma in the head and neck are the oral cavity and larynx. The histopathological diagnosis of verrucous carcinoma should. Typical irritation and inflammation occur at the site of development of the verrucous carcinoma. Papillary and verrucous lesions of the oral mucosa. Histopathological variants of cutaneous squamous cell. Verrucous carcinoma is an extremely rare form of cancer in the esophagus. It is a rare tumour and in 75% of cases it is localised in the oral cavity, and sporadically within the tongue. Verrucous carcinoma journal of oral and maxillofacial pathology. Verrucous carcinoma vc is thought to be a relatively indolent form of scc that presents with bland, verrucouslike features. Penile verrucous carcinoma mckee 1983 histopathology. The analyzed variables were sex, age, localization in the oral cavity, histopathology, number of biopsies needed to diagnose ovc, tnm. One case had focal ordinary squamous cell carcinoma within the vc.
There is paucity of literature regarding control rates in these cases. Verrucous carcinoma vc is a lowgrade squamous cell carcinoma. The main histopathological differential diagnosis of verrucous carcinoma is from leukoplakia, papilloma, pseudoepitheliomatous hyperplasia, verrucous hyperplasia and highly differentiated squamous cell carcinoma. Verrucous carcinoma may involve the oral cavity, larynx, anogenital region, plantar surface of the foot, and, less commonly, other cutaneous sites. A 56yearold woman presented with dysphagia in 2007. The term verrucous carcinoma vc was coined by ackerman2 to describe a group of lesions with distinctive clinicopathologic features that were different from other forms of squamous cell carcinoma scc. Vc is a variant of well differ entiated squamous cell carcinoma. Verrucous carcinoma of the buccal mucosa with extension to. Oral verrucous carcinoma ovc, a variant of squamous cell. Several subtypes of verrucous carcinoma have been described. Oral verrucous carcinoma ovc is an uncommon variant of oral squamous cell carcinoma oscc. This can sometimes be a challenging procedure, depending on the location of the tumor. Differential diagnosis can be made histologically, but a biopsy. Suspect if a longstanding verrucous lesion is unresponsive to routine treatment indian dermatol online j 2014.
Verrucous carcinoma describes a low grade squamous cell carcinoma affecting skin and mucosa with characteristic slow growth, minimal local invasion and only rare metastases. A malignant neoplasm arising in scar tissue is a wellknown but rare phenomenon commonly called marjolin ulcer, named after french physician jean nicolas marjolin. Treatment of verrucous carcinoma with radiation therapy should be avoided due to the risk of anaplastic transformation. The pathological features of these tumours are described and the aetiology of penile verrucous carcinoma is discussed. Verrucous carcinoma vc is a rare type of lowgrade, well differentiated squamous cell carcinoma, and develops mainly in the skin, genitalia, esophagus, and oral cavity. Although malignant, this variant does present with characteristics of a benign tumor. Verrucous carcinoma of the oral cavity international.
The oral cavity is the most common site of this tumor. To study the clinicopathological features of oral verrucous carcinoma vc. Verrucous carcinoma american urological association. Enormous effort has been dedicated to this cancer, and the past decades have witnessed significant advances in relevant diagnostic and therapeutic. Verrucous carcinoma of the anus surgical pathology. The most common site of origin of this type of cancer normally develops in gingiva gums, alveolar mucosa and buccal mucosa of the oral cavity or buccal cavity. Giant condyloma acuminatum buschkelowenstein tumor. Good prognosis is characteristic for this tumour, since the 5year survival is 93%. Here we report a case of verrucous carcinoma vc arising from the floor of the mouth.
Oral verrucous carcinoma is a rare tumor first described by ackerman. Verrucous hyperplasia is a forerunner of verrucous carcinoma, and transition is so consistent that the hyperplasia, once diagnosed, should be treated as verrucous carcinoma. A wide variety of papillary and verrucous lesions can affect the oral mucosa. It has a lower malignancy potential than conventional squamous cell carcinomas. Verrucous carcinoma comprises 212% of all oral carcinomas. Verrucous carcinoma is a slow growing, well demarcated, exophytic variant of squamosus cell carcinoma with a characteristic verrucous presentation. Surgery is the mainstay of treatment of this neoplasm. It has a characteristic multilobular appearance with small surface projections on contrast cystogram. Endoscopic examination revealed an irregular protruding circumferential erosion in the lower thoracic esophagus, but because pathological examination of the biopsy specimen showed no evidence of malignancy, the status of the erosion was followed up by an. Eleven patients with verrucous carcinoma of the penis are presented. Older reports of transformation of verrucous carcinoma following radiation therapy at various sites have not been supported by the recent literature teri a longacre md robert v rouse md department of pathology stanford university school of medicine stanford ca 943055342.
Jun 14, 2017 a wide variety of papillary and verrucous lesions can affect the oral mucosa. Case report verrucous carcinoma a diagnositic dilemma. Dec 29, 2010 verrucous carcinoma vc is thought to be a relatively indolent form of scc that presents with bland, verrucous like features. Verrucous carcinoma of the foot often affects deep structures such as tendons, muscles, or bones. Age, sex, site, tobacco habit, clinical presentation, and histologically, the presence of dysplasia and koilocytic changes were studied. Verrucous carcinoma is a distinct type lowgrade squamous cell carcinoma, which provides cauliflowerlike external lesions. He was treated with multiple excisions and superficial biopsies associated with antibiotic therapy without success. Past history of hyperthyroidism increased appetite, loss of weight, tremors, and menorrhagia present commonest location verrucous carcinoma is the oral cavity, and extraoral sites are genitalia and feet, but on the leg is rare. Apr 20, 2011 verrucous carcinoma vc is a rare type of lowgrade, well differentiated squamous cell carcinoma, and develops mainly in the skin, genitalia, esophagus, and oral cavity. Multiple epitheliomata cuniculata occurring in a mutilating keratoderma. A clinicopathologic dilemma revisited using p53 as immunohistochemical marker.
In addition, it is known to occur in the larynx, pyriform sinus, esophagus, nasal cavity and paranasal. Carcinoma cuniculatum, also known as verrucous carcinoma, is a specific type of squamous cell carcinoma. This is an open access article distributed under the terms of the creative commons attributionnoncommercialsharealike 3. A hybrid verrucous carcinoma hvc is defined as a neoplasm in which there is histological diagnostic verrucous carcinoma vc and a non verrucous squamous cell carcinoma scc arising synchronously from the same maternal field 1, 2. The age range was from 41 to 80 years with a mean of 59 years. The pathogenesis of vc of the oral cavity is thought to be associated with human papilloma virus hpv 1 3, poor oral hygiene, chewing of tobacco, and use of snuff. However, premalignant and malignant verrucous and papillary lesions pose a much greater diagnostic challenge, not helped by often confusing terminology. What is the prognosis of verrucous carcinoma of vagina. We examined the temporal bone histopathology from a patient with. Oral verrucous carcinoma ovc is a verrucous variant of oral squamous cell carcinoma oscc, which accounts for 212% of all oral carcinomas with a 5year survival rate of only approximately 50%. Proliferative verrucous leukoplakia of the gingiva pvlg appears to be a subset of oral proliferative verrucous leukoplakia.
Oral squamous cell carcinoma oscc represents 95% of head and neck malignant carcinoma. Verrucous carcinoma is a low grade variant of squamous cell carcinoma and the clinical features of both are very similar. Treatment of verrucous carcinoma remains controversial. The commonest sites of involvement in the head and neck regions have been oral cavity 29% and larynx 2%. This differentiation is based on the appearance of cells when observed under a microscope by a pathologist. Dec 17, 2017 verrucous carcinoma is a relatively uncommon, locally aggressive, clinically exophytic, lowgrade, slowgrowing, welldifferentiated squamous cell carcinoma with minimal metastatic potential. The published literature suggests that 20 % of initially diagnosed vc patients contained hybrid variety. Head and neck malignant carcinoma is the worlds fifth most common cancer with incidence exceeding half a million annually 1,2. These can reasonably also be considered as verrucous carcinoma and managed accordingly. Various names are used in the literature to describe this entity, including ackermans tumor, buschkeloewenstein tumor, florid oral papillomatosis, epithelioma cuniculatum, and carcinoma. This program was designed to help urology residents and fellows familiarize themselves with the pathologic features of common urologic entities. Vc grows gradually, has a tendency of local invasion and seldom metastasizes. Histopathological examination revealed stratified squamous.