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