What Is Verrucous Carcinoma?

Verrucous carcinoma is a rare squamous cell carcinoma subtype with low malignancy and rarely metastases.

Basic Information

nickname

Oral cauliflower papillomatosis; giant condyloma; penetrating epithelioma

English name

verrucous carcinoma

English alias

oral florid papillomatosis; giant condyloma acuminatum; Buschke-Lowenstein tumor

Visiting department

Dermatology; Oncology

Common locations

Oral cavity, external genitalia, anus, crotch

Common causes

Oral wart cancer: related to chewing tobacco, betel nut, poor oral hygiene, improper dental implantation; external genital, anal wart cancer: caused by HPV6 or HPV11

Common symptoms

Oral verrucous cancer: white cauliflower-like damage, and gums can also be affected; external genital and anal wart cancer: cauliflower-like, papilloma-like hyperplasia, etc

Clinical manifestations of verrucous carcinoma

Oral verrucous carcinoma

Also known as oral cauliflower papillomatosis, first reported by Ackeman in 1948, this disease is rare, accounting for only 4% to 9% of oral malignant tumors. Its occurrence is related to chewing tobacco, betel nut, poor oral hygiene and inappropriate dental implantation. Occurs in elderly men, clinical manifestations of white cauliflower-like damage, gums can also be affected. It can also invade the cheeks and / or jaws.

2. External genital and anal wart cancer

Also known as Great Condyloma. Most cases are caused by HPV6 or HPV11, and the disease accounts for 5% to 25% of penile malignancies. The lesions are cauliflower-like and papilloma-like hyperplasia. They are most common in male glans and uncircumcised foreskins, and eventually penetrate the urethra. Also seen in the vulva and anus, can form ulcers and leaky tubes. It often smells bad.

3. Wart cancer of the palate

Also known as perforating epithelioma. The skin lesions were initially like refractory plantar warts. They were raised plaques that penetrated deep into the deep, forming many deep depressions, which were filled with keratin and pus. The tumor can eventually penetrate the plantar fascia and can even destroy surrounding bones and invade the skin of the back of the foot.

Verrucous cancer examination

Histopathological examination of the skin lesions revealed that the superficial part of the tumor was generally similar to a wart, showing hyperkeratosis, incomplete keratosis, and hypertrophy of the spinous layer. Keratinocytes are well differentiated, eosinophilic, and have small nuclei. The deep part of the tumor invades and grows from the well-differentiated squamous epithelium to the dermis, and the front end grows spherically to form a characteristic squeezing boundary. There are often keratin-filled cysts in the center, and sinuses are formed when there is necrosis. Cell atypia and mitosis are rare.

Verrucous Cancer Treatment

Surgical resection is the best treatment. Some cases require Mohs microsurgery. Smaller tumors can be treated with liquid nitrogen freezing or CO ₂ laser.

Prognosis of verrucous cancer

Most patients get better. The local recurrence rate of oral verrucous cancer is 6% to 40%, and there is rarely metastasis, but it has the risk of developing a second oral primary squamous cell carcinoma.