Verrucous carcinoma

Verrucous carcinoma of the penis

Micrograph of penile verrucous carcinoma at 20x magnification

Micrograph of penile verrucous carcinoma at 200x magnification

Verrucous carcinoma is a rare type of squamous cell carcinoma that is characterized by a slow-growing, exophytic, and warty appearance. It is a well-differentiated form of cancer that typically affects the skin and mucosal surfaces.

Classification

Verrucous carcinoma is classified as a variant of squamous cell carcinoma. It is known for its low metastatic potential but can be locally aggressive. The condition is further categorized based on its location:

• Oral verrucous carcinoma: Also known as oral florid papillomatosis, it occurs in the oral cavity.
• Penile verrucous carcinoma: Affects the penis.
• Plantar verrucous carcinoma: Occurs on the soles of the feet.

Pathophysiology

Verrucous carcinoma is characterized by its exophytic growth pattern, meaning it grows outward rather than invading deeper tissues. Histologically, it shows well-differentiated squamous cells with minimal atypia and a pushing rather than infiltrative border. The tumor often presents as a large, cauliflower-like mass.

Causes

The exact cause of verrucous carcinoma is not well understood, but it is associated with chronic irritation and infection. Human papillomavirus (HPV) infection, particularly HPV types 6 and 11, has been implicated in some cases, especially in genital and oral lesions.

Diagnosis

Diagnosis of verrucous carcinoma is primarily based on clinical examination and histopathological analysis. A biopsy is essential to differentiate it from other types of squamous cell carcinoma and benign lesions such as verruca vulgaris.

Treatment

The primary treatment for verrucous carcinoma is surgical excision with clear margins. Due to its low metastatic potential, lymph node dissection is not typically required unless there is clinical suspicion of metastasis. Other treatment modalities such as radiation therapy and chemotherapy are generally not effective and may even cause anaplastic transformation.

Prognosis

The prognosis for verrucous carcinoma is generally favorable if it is completely excised. However, recurrence is possible if the tumor is not fully removed. Regular follow-up is recommended to monitor for recurrence.

Related Pages

• Squamous cell carcinoma
• Human papillomavirus
• Penile cancer