Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma, for which the prognosis is worse. Verrucous carcinoma was first reported by friedell and rosenthal 1, who described eight lesions of a verrucoid nature in the buccal mucosa. In the oral cavity, verrucous carcinoma constitutes 2% to 4. Verrucous carcinoma was first described in 1948 in the oral cavity surgery 1948. They have well characterised histopathological features, often referred to as conventional squamous cell carcinoma. Verrucous carcinoma ackermans tumor is a low grade variant of oral squamous cell carcinoma oscc.
Verrucous carcinoma is a rare type of cancer with external lesions that appear cauliflowerlike, typically developing at a site of chronic irritation or inflammation. Original article gene profiling analysis for patients with. Verrucous carcinoma vc is a rare oral tumor that is classified under carcinomas owing to characteristics that exists amid a benign verrucous lesion and. A case report a bhagya lakshmi 1, bvs kartheek 1, t krishna kishore 2, and ch nirmala 3. Protocol for the examination of specimens from patients with cancers of the lip and oral cavity. Locally advanced verrucous carcinoma of the oral cavity. In medical inoperable patients or irresectable tumors, highdoserate hdr brachytherapy is a valid alternative. 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.
Verrucous carcinoma grows gradually, has a tendency of local invasion and seldom metastasizes. Clinically, it presents most often as a slowgrowing verrucous lesion. The tumor grows locally invasive but is histologically benign and metastasizes rarely. Ovc is characterized by a slow growing, painless, broad based verrucous or wart like papillary lesion. 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. Differential diagnosis of verrucous carcinoma in the oral cavity and larynx volume 102 issue 8 m. A challenge for the clinician and the pathologist rita a. Generally, verrucous carcinoma affects older women, many in the eighth and ninth decades of life. Verrucous carcinoma vc is a variant of well differentiated squamous cell carcinoma with low malignant potential. We evaluated 12 patients who had developed oral verrucous carcinoma in the past 10 years in a followup study. Ovc is a rare tumor representing only 34% of all carcinoma.
The oral cavity is the most common site of this tumor. Cutaneous verrucous carcinoma is referred to as carcinoma cuniculatum or epithelioma cuniculatum and is predominantly located on the plantar surface of the foot. It rarely occurs in the floor of the mouth and tongue. Vc is a locally invading tumor and does not spread to the local lymph nodes. Verrucous carcinoma and squamous cell papilloma of the oral. 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.
This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and. We present an 85yearold man with functionally irresectable ct3n0m0 verrucous carcinoma superficially spreading along the upper. Carcinomas of the oral cavity histopathology reporting guide. Here we report a case of verrucous carcinoma vc arising from the floor of the mouth. Department of pathology, andhra medical college, visakhapatnam a. 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. The commonest sites of involvement in the head and neck regions have been oral cavity 29% and larynx 2%. Carcinoma cuniculatum of the oral cavity a rare entity moidin shakil, imran mohtesham, maji jose, vishnudas prabhu.
Oral verrucous carcinoma ovc is described apart of the squamous cell carcinoma scc due to its specific properties. Verrucous carcinoma in the oral cavity report of two cases. The commonest site is oral cavity followed by pharynx. A 50 yearold man was presented with complaining of oral discomfort. Case report verrucous carcinoma a diagnositic dilemma. Papillary and verrucous lesions of the oral mucosa. Verrucous carcinoma comprises 212% of all oral carcinomas.
In the oral cavity, the buccal mucosa and lower gingiva is the common site imaiet al, 1995. Ninety percent of oral and pharyngeal cancer cases are classified as squamous cell carcinoma5. Verrucous carcinoma frequently affects multiple organs and tissues including the oral mucosa, esophagus, leg, temporal bone, eye, penis, buttocks, foot, toe, skin, hand etc. This carcinoma has also been reported in the nasal cavity, larynx and esophagus. Ackermann first described this neoplasm of the oral mucous membrane, which is now also know as verrucous carcinoma of ackermann or ackermanns tumor. Oral verrucous carcinoma is a rare tumor first described by ackerman. In this study, the diagnostic criteria included clinical and histopathological features of the lesions. The demographics, clinical presentation, and surgical outcomes of vc are believed to be different from oscc. Verrucous hyperplasia of the oral mucosa is a relatively unrecognized entity that may resemble verrucous carcinoma clinically and histologically.
Verrucous carcinoma is a slow growing, well demarcated, exophytic variant of squamosus cell carcinoma with a characteristic verrucous presentation. Current treatment options include surgery and external beam radiotherapy ebrt. It is difficult to differentiate the lesion from verrucous leukoplakia and verrucous hyperplasia. One patient had a coexistent sub mucous fibrosis, a premalignant lesion and two autoimmune disorders, i. Oral cavity and oropharyngeal cancer what is cancer. The lesions included in this spectrum ranges from benign lesions like papilloma, premalignant lesions like verrucous hyperplasia vh to malignant verrucous carcinoma vc.
Verrucous hyperplasia of the oral mucosa shear 1980. What hiring strategies have worked for you in this covid19 pandemic era. Verrucous carcinoma causes, symptoms, treatment, prognosis. Verrucous carcinoma of the oral cavity, found most commonly on the buccal mucosa, is known as florid oral papillomatosis or ackerman 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%. They are characterized by a unique proliferation of the stratified squamous epithelium. June 2017 includes ptnm requirements from the 8th edition, ajcc staging manual. Aug 22, 20 oral verrucous carcinomas are locally invasive but rarely metastasize. This study describes the clinical and histological features of the condition, particularly in relation to verrucous carcinoma. Therefore, it is important to surgically remove the. Verrucous carcinoma vc is a locally invasive, welldifferentiated, lowgrade squamous cell carcinoma with a low metastatic potential. Proliferative verrucous leukoplakia of the gingiva pvlg appears to be a subset of oral proliferative verrucous leukoplakia. Oral florid papillomatosis is a type of verrucous carcinoma vc that is clinically evident as multiple squamous papillary nodules in the oral cavity and, less commonly, in the larynx, the pharynx, the esophagus, the middle ear, the maxillary antrum, the nasal fossa, and the bronchus. Verrucous carcinoma may involve the oral cavity, larynx, anogenital region, plantar surface of the foot, and, less commonly, other cutaneous sites.
Ulcerative type papillary or verrucous type nodular type scirrhous type all these types appear on a background of leukoplakia or erythroplasia of the oral mucosa. Oral verrucous carcinoma ovc is a distinct low grade variant of squamous cell carcinoma scc 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 vc is a variant of welldifferentiated squamous cell carcinoma ackerman, 1948. Verrucous carcinoma frequently is observed at 3 particular anatomic sites. 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.
Clinical and histopathological diagnosis of these lesions is challenging. Verrucous carcinoma verrucous carcinoma is a type of squamous cell carcinoma that makes up less than 5% of all oral cancers. Verrucous carcinoma often requires correlation with both the clinical and histopathologic findings for definitive diagnosis, as keratinocytes often appear to be well differentiated. Verrucous carcinoma in the oral cavity report of two cases venkateswarlu m1, geetha p2, batchu pavan kumar3, namratha4, sunitha5 abstract. 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. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia or sole of the foot. In this case report we are reporting such a case of verrucous carcinoma which is involving the lower lip. Verrucous carcinoma vc ackermanns tumor is a rare type of lowgrade, well differentiated squamous cell carcinoma, and develops mainly in the skin, genitalia, esophagus, and oral cavity. The oral cavity is one of the predilection sites for vc.
Therefore, at the commencing of the condition may lead to organspecific symptoms including a sore throat, hoarseness, and dysphagia. Dec 17, 2017 verrucous carcinoma is a relatively uncommon, locally aggressive, clinically exophytic, lowgrade, slowgrowing, welldifferentiated squamous cell carcinoma with minimal metastatic potential. Verrucous carcinoma on the lower extremities mdedge. An animal model of buccal mucosa cancer and cervical lymph node metastasis induced by u14 squamous cell carcinoma cells. Pdf verrucous carcinoma vc, a rare variant of squamous cell carcinoma is an. Pdf radiotherapy in the treatment of verrucous carcinoma. 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.
Not a common tumor verrucous carcinoma was first described in 1948 in the oral cavity surgery 1948. Radiotherapy in the treatment of verrucous carcinoma of the oral cavity. Verrucous carcinoma report on two cases padmavathy l, rao l. Oral verrucous carcinoma ovc presents predominantly as an exophytic growth with a. The 5year survival rate was 35% for stage i11 and 26% for stage iv. Those which are benign and reactive, for example squamous papilloma or verruciform xanthoma, usually present little diagnostic difficulty. The papillary or verrucous type lesions are quite common in the oral region, representing 3% of all the biopsied oral lesions. 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. The incidence of vc of the oral cavity is between 2% and 16% of all oral cancers. The information in the rest of this document about oral cavity and oropharyngeal cancer covers. However, dysplastic and malignant verrucous and papillary lesions are a much greater diagnostic challenge, not helped by confusing terminology. Various names are used in the literature to describe this entity, including ackermans tumor, buschkeloewenstein tumor, florid oral papillomatosis, epithelioma cuniculatum, and carcinoma. Verrucous carcinoma carcinoma cuniculatum of the head and neck.
They are generally considered as slow growing tumors with good prognosis. Intraoral verrucous carcinoma of the right buccal mucosa in case 1. The usual location of the verrucous carcinoma is oral cavity and may involve multiple organs including throat, nasal cavity buccal mucosa, and larynx. The most usual site of occurrence is oral cavity, accounting for 75% of cases involved 1. Two cases of verrucous carcinoma affecting the lip and oral mucous membrane oral florid papillomatosis are being reported. Denver general hospital a case of a large verrucous carcinoma in a 72yearold man is reported.
Verrucous carcinoma is a rare form of welldifferentiated squamous cell carcinoma with distinctive biologic features. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia. It is a rare tumour and in 75% of cases it is localised in the oral cavity, and sporadically within the tongue. Farthing1 squamous cell carcinoma of the oral cavity oral cancer oral squamous cell carcinomas arise from the epithelial lining of the oral cavity. Verrucous carcinoma of the foot diagnosed using p53 and ki.
National survey of head and neck verrucous carcinoma. Verrucous carcinoma verrucuous carcinoma is an uncommon kind of welldifferentiated squamous cell carcinoma. It is felt that the treatment policy for verrucous carcinoma. The pathogenesis of vc of the oral cavity is still obscure, but is thought to be associated with human papilloma virus hpv 1 3, poor oral. A variety of verrucous and papillary lesions affect the oral mucosa. The pathogenesis of vc of the oral cavity is still obscure, but is thought to be associated with human papilloma virus hpv 1 3, poor oral hygiene, chewing of tobacco, and use of snuff. Verrucous carcinoma an overview sciencedirect topics. Differential diagnosis of verrucous carcinoma in the oral cavity and. Oral verrucous carcinoma ovc is an uncommon variant of oral squamous cell carcinoma oscc. 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. Carcinoma cuniculatum of the oral cavity a rare entity. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Grossly, squamous cell carcinoma of oral cavity may have the following types. Ackermanns tumor, oral verrucous carcinoma, verrucous hyperplasia.
Pdf on mar 11, 2015, nitin kaushal bds and others published verrucous carcinoma of the oral cavity find, read and cite all. Statistical analysis was performed using the spss softwareversionfor11. Proliferative verrucous leukoplakia pvl is a disease of extensive or. The striking difference in the distribution of gender between the oral cavity and other head and neck sites has been addressed previously. The ages range from 50 to 80 years with a male predominance and a median age of 67 years. To date, 22 cases of verrucous carcinoma involving the nasal cavity andor the paranasal. Oral cancer is a type of head and neck cancer and is any cancerous tissue growth located in the. Verrucous carcinoma also called as ackermans tumor is a subtype of low. Oral verrucous carcinoma vc is a rare locally invasive tumor. The frequently sites of oral verrucous carcinoma ovc were the lower lip 20. For accreditation purposes, this protocol should be used for the following procedures and tumor types.
Verrucous carcinoma is an uncommon but distinct variety of well differentiated squamous cell carcinoma. We use your linkedin profile and activity data to personalize ads and to show you more relevant ads. The treatment results with radiotherapy were comparable with those for ordinary squamous cell carcinoma of the oral cavity. Verrucous carcinoma of the oral cavity international.
Early squamous cell carcinoma often presents as a white lesion leukoplakia, red. Verrucous carcinoma of the tongue a rare case study. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. It is a lowgrade slow growing cancer that rarely spreads to other parts of the body, but it can grow deeply into surrounding tissue. Verrucous carcinoma of the oral cavity report of a case chris bohmfalk, d. A majority of the benign vpls have viral aetiology and include commonly occurring squamous papilloma along with verruca vulgaris, focal epithelial hyperplasia, and condyloma. Enormous effort has been dedicated to this cancer, and the past decades have witnessed significant advances in relevant diagnostic and therapeutic. Verrucous papillary lesions vpls of oral cavity are diagnostically challenging as they include a spectrum of benign, potentially malignant, and frankly malignant lesions. An association between human papilloma virus and verrucous carcinoma has also been proposed. Unlike squamous cell carcinomas of the usual variety, verrucous carcinoma infiltrates by a broad pushing margin and rarely metastasizes. It is a lowgrade slow growing cancer that rarely spreads to other parts. Vc of the foot is rare and presents as an enlarging, cauliflowerlike tumor.
Oct 27, 20 grossly, squamous cell carcinoma of oral cavity may have the following types. It is a lowgrade cancer that rarely spreads to other parts of the body but can deeply spread into surrounding tissue. Exophytic verrucous hyperplasia of the oral cavity. Proliferative verrucous leukoplakia pvl is a disease of extensive or multifocal verrucous like lesions that has a high risk of recurrence and malignant transformation into a carcinoma. Verrucous hyperplasia vh is the histopathological finding most likely representing part of the pvl diagnosis. Verrucous carcinoma verrucous carcinoma is a type of squamous cell carcinoma that makes up less than 5% of all oral cavity tumors. Differential diagnosis of verrucous carcinoma in the oral. Verrucous carcinoma usually appears in 3 main sites. 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.
It most commonly is seen in late middleaged men 85% of cases and presents as a slowgrowing mass, often of more than 10 years duration. Here we are presenting such a case of verrucous carcinoma over the leg unusual site. Metastasis to lymph nodes or distant organs is rare. A clinicopathologic appraisal of 3 cases in indians article pdf available in oral and maxillofacial surgery 144. The histopathological diagnosis of verrucous carcinoma should be accompanied with careful identification of tumors with a greater chance to become frank cancers. Oral cavity and oropharyngeal cancer oral surgery oral. Verrucous carcinoma associated with oral submucous fibrosis that.