Verrucous carcinoma of the leg a rare variant of squamous. Epithelioma cuniculatum also known as carcinoma cuniculatum. The pathogenesis of vc of the oral cavity is thought to be associated with human papilloma virus hpv, poor oral. The 5year survival rate was 35% for stage i11 and 26% for stage iv. In our series, verrucous carcinoma of the oral cavity, with respect to all patients with oral cavity cancer, represents the 6. 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. This study describes the clinical and histological features of the condition, particularly in relation to verrucous carcinoma. Verrucous carcinoma vc first described in 1948 by lauren v. 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%. Three cases of multiple vcs of other sites have been reported 79. Based on the literature, verrucous carcinoma accounts for approximately. A predilection for the mucosa of the oral cavity of tobacco chewers has been noted 1,2, 11, but the lesion also occurs in the larynx and on the squamous mucosa of the vulva, vagina, and glans penis 15. Verrucous carcinoma vc of oral cavity is a rare variant of welldifferentiated squamous cell carcinoma and squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass.
Verrucous carcinoma of the oral cavity international. The oral cavity is the most common site of this tumor. The most usual site of occurrence is oral cavity, accounting for 75% of cases involved 1. Verrucous carcinoma is a rare type of cancer with external lesions that appear cauliflowerlike, typically developing at a site of chronic irritation or inflammation. Usually, ovc presents a high tendency of local invasion, with a low tendency of dissemination, which varies depending on tumour size and evolution time 2, with a very low tendency to metastasize. 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. Verrucous hyperplasia of the oral mucosa shear 1980. Cutaneous verrucous carcinoma is referred to as carcinoma cuniculatum or epithelioma cuniculatum and is predominantly located on the plantar surface of the foot. Statistical analysis was performed using the spss softwareversionfor11. The lesions included in this spectrum ranges from benign lesions like papilloma, premalignant lesions like verrucous hyperplasia vh to malignant verrucous carcinoma vc. A clinical and pathological study of 101 cases article in oral oncology 451. Although hpv types 6, 11, 16 and 18 have been detected to varying degrees in verrucous carcinoma of the oral cavity and the larynx10,11. Ovc is characterized by a slow growing, painless, broad based verrucous or wart like papillary lesion. Verrucous carcinoma registered dental hygienist rdh magazine.
Ackerman 1 is a form of squamous cell carcinoma with specific clinical, morphologic and cytokinetic features. Verrucous carcinoma is found more often in individuals with a history of smoking, and this type of cancer appears to affect males more often in the age range of 55 or older who have used spit tobacco, pan, bidis, or smoked cigarettes for many years. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia. Epidemiology and followup of oral verrucous carcinoma e508 discussion the prevalence of ovc for total carcinomas affecting the oral cavity and oropharynx is low, and as revised in rekha et al. Metastasis to lymph nodes or distant organs is rare. Seer data indicate that the estimated new cases of oral cancer in 2014 to be 42,440, with oral cancer in 2. A challenge for the clinician and the pathologist author links open overlay panel rita a. Our study documents, for the first time, the coexistence of foci of lessdifferentiated squamous carcinoma within verrucous lesions of the oral cavity 20%. Laberke skip to main content we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Reports on satisfactory results of treatment of verrucous carcinoma with surgery and diathermy have appeared in the literature 11, 15, 21.
Verrucous carcinoma ackermans tumor is a low grade variant of oral squamous cell carcinoma oscc. The etiology of verrucous carcinoma is not clear, and the role of human papillomavirus hpv infection is controversial. Verrucous carcinoma of the oral cavity, found most commonly on the buccal mucosa, is known as florid oral papillomatosis or ackerman carcinoma. In the current literature, 16 although the most common site for verrucous carcinoma is the buccal mucosa, the most affected areas in the present study were the mandibular retromolar and molar area 41. A case report a bhagya lakshmi 1, bvs kartheek 1, t krishna kishore 2, and ch nirmala 3. Verrucous carcinoma is a distinctive, extremely welldifferentiated, slowgrowing variant of the squamous cell carcinoma. Improved outcomes were not shown with the addition of radiation therapy to surgery. Pdf radiotherapy in the treatment of verrucous carcinoma of. Verrucous carcinoma verrucuous carcinoma is an uncommon kind of welldifferentiated squamous cell carcinoma.
It is a rare tumour and in 75% of cases it is localised in the oral cavity, and sporadically within the tongue. Verrucous hyperplasia is considered to be an early form of verrucous carcinoma and recommended to. Carcinomas of the oral cavity histopathology reporting guide. Verrucous carcinoma on the lower extremities mdedge dermatology.
Clinical and histopathological diagnosis of these lesions is challenging. Verrucous carcinoma is a lowgrade variant of squamous cell carcinoma reported to occur in all anatomic sites in the head and neck region, most commonly the oral cavity. Verrucous hyperplasia is considered to be an early form of verrucous carcinoma and recommended to be treated accordingly. What hiring strategies have worked for you in this covid19 pandemic era. To analyze the impact of adjuvant radiation therapy rt on overall survival os and disease. Carcinoma cuniculatum of the oral cavity a rare entity. Department of pathology, andhra medical college, visakhapatnam a.
Generally, verrucous carcinoma affects older women, many in the eighth and ninth decades of life. About 5 percent of all oral cavity tumors are verrucous carcinoma, a type of very slowgrowing cancer made up of squamous cells. The oral cavity is the most common site for this type of tumor, as well as other areas such as the larynx, nasal cavity and throat. In the oral cavity, the buccal mucosa and lower gingiva is the common site imai et al, 1995. Verrucous carcinomas of the rectum, plantar surface of the foot, and oral cavity were studied by means of light and electron microscopy, and autoradiographic and immunofluorescent techniques. Verrucous carcinoma causes, symptoms, treatment, prognosis. The purpose of this clinical study was to identify a clinical and histopathological relationship between verrucous hyperplasia, verrucous keratosis, and verrucous carcinoma.
Pvl is a disease of the oral cavity in which vh is a part of its developmental spectrum. Verrucous hyperplasia of the oral cavity application of standardized criteria for diagnosis asian pac j cancer prev, 17 9, 44914501 introduction verrucopapillary lesions vpls of the oral cavity include benign, potentially malignant and frankly malignant disorders. 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. To date, 22 cases of verrucous carcinoma involving the nasal cavity andor the paranasal. Its a lowgrade slow growing cancer that rarely spreads to other parts of the body, but it can grow deeply into nearby tissue.
Verrucous carcinoma also called as ackermans tumor is a subtype of low. The papillary or verrucous type lesions are quite common in the oral region, representing 3% of all the biopsied oral lesions. Verrucous carcinoma of the oral cavity wiley online library. Verrucous carcinoma is a slow growing, well demarcated, exophytic variant of squamosus cell carcinoma with a characteristic verrucous presentation. Verrucous carcinoma of oral cavity is a highly well differentiated variant of squamous cell carcinoma with a low potential for invasion and metastasis. Verrucous carcinoma clearly represents a distinct variant of squamous cell carcinoma, and. Verrucous carcinoma in the oral cavity report of two cases. There is a certain clinical similarity between squamous cell papilloma and vc. One hundred four patients had verrucous carcinomas of the oral cavity. Surgical excision alone is the most common treatment of verrucous carcinoma. According to the american cancer society, less than 5% of all oral cancers are of the verrucous type. Verrucous carcinoma of the tongue a rare case study. Enormous effort has been dedicated to this cancer, and the past decades have witnessed significant advances in relevant diagnostic and therapeutic.
It is a slow growing tumor, which presents predominantly as an exophytic growth with a pebbly, micronodular surface and tends to spread locally. Oral verrucous carcinoma ovc presents predominantly as an exophytic growth. However, dysplastic and malignant verrucous and papillary lesions are a much greater diagnostic challenge, not helped by confusing terminology. Oral verrucous carcinoma ovc is a distinct low grade variant of squamous cell carcinoma scc of the oral cavity. A wide variety of papillary and verrucous lesions can affect the oral mucosa. An association between human papilloma virus and verrucous carcinoma has also been proposed. Verrucous carcinomas typically are slow growing, exophytic, and low grade. Here we are presenting such a case of verrucous carcinoma over the leg unusual site. Verrucous carcinoma usually debuts as an abnormal growth or as change in the consistency of a previous potentially malignant disorder of the. Ovc is a rare tumor representing only 34% of all carcinoma. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia or sole of the foot. It is felt that the treatment policy for verrucous carcinoma. Verrucous carcinoma grows gradually, has a tendency of local invasion and seldom metastasizes. Verrucous carcinoma in the oral cavity report of two cases venkateswarlu m1, geetha p2, batchu pavan kumar3, namratha4, sunitha5 abstract.
Anaplastic transformation in verrucous carcinoma of the oral. Case report verrucous carcinoma a diagnositic dilemma. Verrucous carcinoma on the lower extremities mdedge. National survey of head and neck verrucous carcinoma koch. Radiotherapy in the treatment of verrucous carcinoma of the oral cavity. Verrucous carcinoma associated with oral submucous fibrosis that. Verrucous carcinoma an overview sciencedirect topics.
All of them are solitary vc, and multiple vcs of the oral cavity have not been reported, to the best of the authors knowledge. Differential diagnosis of verrucous carcinoma in the oral cavity and larynx volume 102 issue 8 m. Verrucous carcinoma vc is a rare oral tumor that is classified under carcinomas owing to characteristics that exists amid a benign verrucous lesion and. Differential diagnosis of verrucous carcinoma in the oral. Vc may occur in several locations in the head and neck and in the genitalia.
It rarely occurs in the floor of the mouth and tongue. The tumor grows locally invasive but is histologically benign and metastasizes rarely. In the oral cavity, verrucous carcinoma constitutes 2% to 4. The verrucous carcinoma was described by lv ackerman in 1948 as an infrequent subtype of malignant disease which affects oral cavity. We confirm previous observations that verrucous lesions tend to recur. A variety of verrucous and papillary lesions affect the oral mucosa. Verrucous carcinoma describes a low grade squamous cell carcinoma affecting skin and mucosa with characteristic slow growth, minimal local invasion and only rare metastases suspect if a longstanding verrucous lesion is unresponsive to routine treatment indian dermatol online j 2014. 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.
The ages range from 50 to 80 years with a male predominance and a median age of 67 years. This rare morphological variant of squamous cell carcinoma was originally reported on the sole of the foot. Verrucous carcinoma and squamous cell papilloma of the. Denver general hospital a case of a large verrucous carcinoma in a 72yearold man is reported. They are characterized by a unique proliferation of the stratified squamous epithelium.
Verrucous carcinoma and squamous cell papilloma of the oral. Verrucous carcinoma registered dental hygienist rdh. Alkan 2010 in a study of 12 cases of verrucous carcinoma reported a ratio of 1. Pdf radiotherapy in the treatment of verrucous carcinoma. Verrucous carcinoma is a type of squamous cell carcinoma that makes up less than 5% of all oral cancers. Initial management with irradiation alone resulted in notably worse survival compared with surgical treatment for both laryngeal and oral cavity verrucous carcinoma. Fiftytwo cases of oral verrucous carcinoma treated with radiotherapy at the regional cancer centre, trivandrum, kerala, india in 1982 were evaluated to determine the distribution within the oral. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. The commonest sites of involvement in the head and neck regions have been oral cavity 29% and larynx 2%.
The treatment results with radiotherapy were comparable with those for ordinary squamous cell carcinoma of the oral cavity. Adjuvant radiotherapy is not supported in patients with. Verrucous carcinoma is a rare form of welldifferentiated squamous cell carcinoma with distinctive biologic features. Exophytic verrucous hyperplasia of the oral cavity. In addition, poor dental hygiene and illfitting dentures can also cause oral lesion and that can turn to verrucous carcinoma 1,3. Verrucous carcinoma of the buccal mucosa with extension to. In 1948, ackerman first described the characteristics of verrucous carcinoma vc, a variant of epidermoid malignancy of the oral cavity, that has since been. Since then, it has been described in other sites, such as the anus, penis, and the female genitalia 1. 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. This type of oral cancer rarely spreads to other parts of the body, but it may invade nearby tissue.
Pdf verrucous carcinoma vc, a rare variant of squamous cell carcinoma is an established entity with distinctive morphology and specific. Those which are benign and reactive, for example squamous papilloma or verruciform xanthoma, usually present little diagnostic difficulty. A retrospective analysis for clinicopathologic features wanjari g sonalika, tegginamani anand department of oral and maxillofacial pathology, hitkarini dental college and hospital, jabalpur, madhya pradesh, india. Verrucous carcinoma is a rare, extremely well differentiated squamous carcinoma with low clinical malignant potential first described in 1948 in the oral cavity 1. Ackermann first described this neoplasm of the oral mucous membrane, which is now also know as verrucous carcinoma of ackermann or ackermanns tumor. The histopathological diagnosis of verrucous carcinoma should be accompanied with careful identification of tumors with a greater chance to become frank cancers. Human papillomavirus, as a cofactor, may play an important role in some of the lesions. Verrucous carcinoma is an uncommon but distinct variety of well differentiated squamous cell carcinoma. Verrucous carcinoma of the oral cavity report of a case chris bohmfalk, d. However, premalignant and malignant verrucous and papillary lesions pose a much greater diagnostic challenge, not helped by often confusing terminology. Ackermans tumour or verucous carcinoma is a unique clinicopathological variant of squamous cell carcinoma, occuring mainly in oral cavity and larynx, buccal mucosa being most commonly involved.
National survey of head and neck verrucous carcinoma. Unlike squamous cell carcinomas of the usual variety, verrucous carcinoma infiltrates by a broad pushing margin and rarely metastasizes. The usual location of the verrucous carcinoma is oral cavity and may involve multiple organs including throat, nasal cavity buccal mucosa, and larynx. We evaluated 12 patients who had developed oral verrucous carcinoma in the past. Papillary and verrucous lesions of the oral mucosa. Several studies of vc of the oral cavity have been reported 46. Hybrid verrucous squamous carcinoma of the oral cavity.
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