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At least 19 recordsLinked to original sources

PubMed1998

[Unusual variant of laryngeal squamous cell carcinoma: verrucous carcinoma].

Verrucous carcinoma is an uncommon but distinctive variety of squamous cell carcinoma, accounting for 1 to 2% of all laryngeal neoplasms. It was first described as a distinct clinicopathological entity by Ackerman in 1948. It has been described most frequently in oral cavity and larynx, but other sites are possible. The preferred location of verrucous carcinoma of the larynx is supraglottic. Its general similarity with papillomas and other papillomavirus-induced lesions has raised the question of a viral etiology (human papillomavirus); HPV-16-related DNA sequences have been found in some verrucous carcinomas using a DNA hybridization technique. We report two cases of verrucous carcinoma and discuss some interesting particularities of these tumors: origin, clinical features, pathology and prognosis.

Carcinoma, Squamous Cell↗

PubMed2002

Comparative study in the expression of p53, EGFR, TGF-alpha, and cyclin D1 in verrucous carcinoma, verrucous hyperplasia, and squamous cell carcinoma of head and neck region.

Verrucous carcinoma (VC) is a locally invasive, nonmetastasizing variant of squamous cell carcinoma (SCC) with distinct clinical and histologic features. Molecular alterations detectable by immunohistochemical analyses in VC have not been extensively studied. This study investigates the expression of p53, epidermal growth factor receptor (EGFR), transforming growth factor-alpha (TGF-alpha), and cyclin D1 in VC, verrucous hyperplasia (VH), and classic SCC of the head and neck. Twenty-six cases of VC, 12 cases of SCC of various differentiations, and 4 cases of VH were studied. Formalin-fixed, paraffin-embedded archival material was used for immunohistochemistry (avidin-biotin immunoperoxidase technique) to study the expression of oncogenes and their tumor markers. Identification of p53 protein was found in 100% of VH, 88% of VC, and 100% of SCC. EGFR expression was noted in 25% of VH, 54% of VC, 40% of well-differentiated SCC (WDSCC), and 100% of moderately and poorly differentiated SCC (MDSCC/PDSCC). TGF-alpha was detected in 25% of VH, 88% of VC, 80% WDSCC, and 100% of MDSCC/PDSCC. Cyclin-D1 expression was seen in 75% of VH, 35% of VC, 100% of WDSCC, 67% of MDSCC, and 50% of PDSCC. Correlation between the level of expression of all markers and the grade of this group of squamous lesions revealed statistically significant correlation coefficients for p53 and EGFR but not for TGF-alpha and cyclin D1.

Biomarkers, Tumor↗

PubMed1998

Three cases of verrucous carcinoma.

Verrucous carcinoma of the skin and mucosa is an uncommon clinicopathological variant of low grade squamous cell carcinoma. Here, we present three different clinical types of verrucous carcinoma. The first patient presented with an anogenital verrucous carcinoma, also known as Buschke-Loewenstein tumour. The second patient had verrucous carcinoma of the heel with endophytic growth (i.e. epithelioma cuniculatum) and the third patient had gluteal verrucous carcinoma with a cauliflower-like appearance. Clinically, the lesion of the first patient best resembled giant condyloma accuminatum without any prominent verrucous component, whereas the second patient showed a big deep ulcer on the heel. None of the patients had metastasis. The diagnosis was confirmed with biopsy and total excision was performed in all cases. Although the cases have different clinical presentations in different locations, we think that they should be considered as a single entity; that is, verrucous carcinoma.

Adult↗

PubMedDate not supplied

Invasive squamous cell carcinoma arising from verrucous carcinoma. Recognition of verrucous carcinoma of skin as an in situ carcinoma.

In 1948, Ackerman first coined the term "verrucous carcinoma" to describe a variant of well-differentiated squamous cell carcinomas of the oral cavity. Similar lesions of the skin, other mucosa or mucocutaneous regions were subsequently reported. To date, verrucous carcinoma has been considered to be a variant of well-differentiated squamous cell carcinoma, which sometimes shows invasive changes but rarely metastasizes. In this study, findings for 3 patients with verrucous carcinomas in which foci of invasive squamous cell carcinoma existed are presented. Furthermore, the clinical features of 9 patients with verrucous carcinoma of the skin observed in our hospital between 1990 and 2004 are summarized. Lesions were located on the face, trunk or extremities. Foci of invasive squamous cell carcinoma were found in 30% of verrucous carcinomas, almost equal to the reported rate of verrucous carcinoma in oral or penile regions. Verrucous carcinoma of the skin should be recognized as a unique subtype of in situ carcinomas, which show exophytic nodular growth and are potentially malignant.

Adult↗

PubMed2004

[Oral verrucous carcinoma].

Verrucous carcinoma is a rare, low-grade, well-differentiated form of squamous cell carcinoma seen on skin and mucosa. It is a slow-growing and locally aggressive tumor whose standard treatment is surgery. A case of strongly invasive oral verrucous carcinoma is presented with the medical history. The differential diagnosis of this neoplasm is difficult and requires clinic and pathologic data confrontation. In this paper, the importance of knowing the malignant potential of this lesion is stressed. Indeed, in 20% of verrucous carcinoma, foci of squamous cell carcinoma can be found. A review of literature and a differential diagnosis of verrucous carcinoma are presented.

Biopsy↗

PubMed2001

Cutaneous verrucous carcinoma.

Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell carcinoma most commonly seen on mucosa. It has been infrequently reported to occur on the skin, where it is a slow-growing and locally aggressive tumour. It is not uncommon for cutaneous verrucous carcinomas to be mistaken for the more frequent verruca vulgaris and treated accordingly. Three cases of cutaneous verrucous carcinoma are presented with the medical history and follow-up data. Surgery is the treatment of choice; these lesions may sustain a potentially anaplastic transformation after radiation therapy.

Aged↗

PubMed2000

[Presternal verrucous carcinoma].

Verrucous carcinomas represent rare, highly differentiated variants of squamous cell carcinoma. They preferentially develop on the oropharyngeal mucosa (Ackerman tumor), the urogenital mucosa (Buschke-Loewenstein tumors), and the soles of the feet (epitheliomata cuniculata). Various synonyma have been coined for these tumors. We report the uncommon occurrence of a large verrucous carcinoma on apparently uninvolved chest skin of a 79-year old patient. The tumor was excised radically. Complete extirpation was confirmed histologically and there was no sign of recurrence during a 3 month observation period. The clinical appearance, histomorphological features, epidemiological aspects, differential diagnosis, therapy, and nomenclature of verrucous carcinomas are discussed.

Aged↗

PubMed2002

Lethal cutaneous verrucous carcinoma.

Verrucous carcinoma is a rare subtype of well-differentiated squamous cell carcinoma that may occur anywhere on the skin. It is slow growing, enlarging relentlessly and invading locally. Some cases were reported to occur on chronic scar tissue but demonstrated the same clinical course than in other locations. Herein, we report on a very unusual case of cutaneous verrucous carcinoma arisen from a long-standing (40 years old) burn scar and which involved the pleura five years after the initial surgical resection. To our best knowledge, this is the first case of pleural involvement by a verrucous carcinoma originating from the skin.

Aged↗

PubMed1986

The pathology of vulvar squamous cell carcinoma and verrucous carcinoma.

Squamous cell carcinoma is far more common than verrucous carcinoma in the vulva. The clinical and morphologic distinctions between these neoplasms are important to understand because of their contrasting biologic behavior and treatment. Both cancers present with symptoms of pruritus and a noticeable mass. On examination, both tumors commonly occur on the labia and are exophytic. If infection occurs in association with verrucous carcinoma, the resulting induration of the surrounding tissue as well as reactive regional lymph node enlargement may fool the clinician into making an erroneous diagnosis of advanced squamous cell carcinoma. In the 33 percent of cases in which a squamous cell carcinoma is flat and ulcerated, the gross distinction from verrucous carcinoma is easy to perceive. The microscopic analysis of squamous cell carcinomas should specify the neoplastic thickness, depth of stromal invasion, and presence or absence of lymphatic invasion since these parameters are important in predicting the probability of lymph node metastases in superficially invasive cancers. Verrucous carcinomas are thick neoplasms which may invade and compress the underlying stroma with "pushing" margins. It is therefore crucial to recognize the microscopic features of this well-differentiated squamous neoplasm in order not to mistake it for a squamous cell carcinoma which has the capacity to metastasize to inguinal lymph nodes. Human papilloma virus has been implicated in the development of both of these tumors. The treatment for verrucous carcinoma is wide local excision. Because recurrence may occur if the surgical resection margins are involved by the neoplasm, the pathologist must carefully evaluate these margins. It is important to note that recurrence of verrucous carcinoma connotes a poor prognosis. The treatment of a squamous cell carcinoma which is thicker than 2 mm or has a stromal invasion depth of more than 1 mm is vulvectomy and bilateral lymph node dissection. If the neoplasm is less than 2 mm in thickness, regional lymph node metastases have not been reported and lymph node dissection may not be necessary. The best treatment option is wide local excision and close follow-up. As our understanding of superficially invasive vulvar squamous cell carcinoma continues to evolve, however, these recommendations may change.

Carcinoma, Papillary↗

PubMed2001

[Long-term course of laryngeal verrucous carcinoma].

Verrucous carcinoma is an odd kind from squamous or epidermoid carcinoma, amounting between 1 and 3.5% percent of the whole number of laryngeal growths. Its predominant sitting is glottic and are characterized through the pathological anatomy and its good prognosis. We report one case treated in our Department which evolved during 14 years and we point out its good prognosis and other particularities regarding its etiology, pathologic anatomy and diagnosis.

Carcinoma, Verrucous↗

PubMed2003

Immunohistochemical expression of Mdm2 and p53 in penile verrucous carcinoma.

Verrucous carcinoma (VC) of the penis is an uncommon squamous tumor that pursues a biologically indolent course. Unlike conventional squamous cell carcinoma (SCC) of the penis, pathogenic roles for human papillomavirus (HPV) infection and p53 mutation have not been reported in VC. We compared the immunohistochemical expression of Mdm2 and p53 in 7 cases of VC and 7 cases of SCC. The Mdm2 gene product preferentially labeled the perinuclear membrane in the granular layer of VC tumor cells, whereas SCC cases showed weak, focal, cytoplasmic staining for Mdm2. The mean labeling index for Mdm2 was higher in VC compared to SCC [79.3 (SE +/- 7.2) in VC vs 18.3 (SE +/- 2.4) in SCC, p < 0.001]. In SCC cases, the normal surrounding skin showed mild granular-layer staining and dysplastic foci that failed to stain with Mdm2 antibody. Weak p53 immunolabeling was seen within nuclei of scattered tumor cells in the cases of VC, whereas the SCC cases showed strong nuclear staining of p53 throughout the tumors. The mean labeling index for p53 was lower in VC compared to SCC [24.8 (SE +/- 3.9) in VC vs 64.7 (SE +/- 9.0) in SCC, p < 0.01]. In SCC cases, the normal surrounding skin showed moderate staining for p53, preferentially confined to the basal layer. Dysplastic foci in the cases of SCC showed increased p53 labeling. In summary, immunohistochemical analysis showed significantly different levels of expression of Mdm2 and p53 in penile VC vs SCC. Overexpression of the Mdm2 gene product may be important in the pathogenesis of VC. Since Mdm2 is a negative regulator of p53, overexpression of Mdm2 may explain why p53 is down-regulated and, therefore, permissive to oncogenic transformation.

Carcinoma, Squamous Cell↗

PubMed1985

Oral verrucous carcinoma.

Verrucous carcinoma is a well-defined variant of the squamous cell carcinoma. Although it is reported to be rare in the Scandinavian countries, 16 cases have been diagnosed in the Southern part of Norway from 1975 to 1982. The clinical and histological characteristics were investigated. The most common site of occurrence was the mandibular alveolar ridge. The average age was 71 years, and unlike most other series of verrucous carcinoma, there was a female predominance and use of tobacco seemed to be the exception. The patients mainly complained of ill-fitting dentures. Adequate surgical excision appears to be the treatment of choice.

Aged↗

PubMed2007

Cyclin D1 expression in oral squamous cell carcinoma and verrucous carcinoma: correlation with histological differentiation.

OBJECTIVE: To assess the expression of cyclin D1 in oral squamous cell carcinoma (OSCC) and verrucous carcinoma (VC), to compare its expression in both of these carcinomas, and to investigate the possible correlation of cyclin D1 expression in different histological grades of OSCC. STUDY DESIGN: Paraffin embedded tissues from 71 cases of OSCC and VC were studied immunohistochemically. Expression of protein was correlated between the 2 entities and in different grades of OSCC. RESULTS: Cyclin D1 overexpression was seen in 29 cases (70.7%) of OSCC and in 19 cases (63.3%) of verrucous carcinoma. Statistical significance at the 5% level was observed for cyclin D1 expression between all categories of squamous cell carcinoma (SCC), that is, between well-differentiated and moderately differentiated carcinomas, and between moderate and poorly differentiated carcinomas, and well and poorly differentiated squamous carcinomas. No statistical significance was observed in cyclin D1 expression between SCC and oral verrucous carcinoma; however, statistical significance was seen between oral VC and poorly differentiated squamous cell carcinoma. CONCLUSION: Increased expression of cyclin D1 significantly correlated with lack of differentiation in these malignant epithelial neoplasms.

Carcinoma, Squamous Cell↗

PubMed2004

Vulvar acanthosis with altered differentiation: a precursor to verrucous carcinoma?

Verrucous carcinoma (VC) of the vulva is a rare variant of squamous cell carcinoma (SCC) of the vulva that afflicts older women and is characterized by a well-differentiated morphology with minimal nuclear atypia. The pathogenesis of VC is uncertain and a putative role for human papillomavirus (HPV) is doubtful. We analyzed 9 vulvar VCs from 7 patients diagnosed as VC of the vulva over the past 10 years at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center. The patients ranged from 75 to 93 years in age (median, 83 years). One also involved the vagina and another coexisted with a keratinizing SCC. VC was associated with lichen sclerosus in 1 case; 7 others contained lichen simplex chronicus with verrucous architecture. In 7 cases, a distinctive noninvasive squamous epithelial proliferation, exhibiting a triad of marked acanthosis with variable verruciform architecture, loss of the granular cell layer with superficial epithelial cell pallor, and multilayered parakeratosis. We have designated these changes vulvar acanthosis with altered differentiation. In 5 of the 9 lesions, formalin-fixed, paraffin-embedded material was available for polymerase chain reaction analysis of HPV nucleic acids and all scored HPV negative. In conclusion, VC is a rare HPV-negative neoplasm that may be associated with other HPV-negative SCCs or its precursors, shares similar morphologic risk factors (lichen sclerosus and lichen simplex chronicus), and is frequently associated with an unusual intraepithelial lesion that can be distinguished from both classic and differentiated forms of vulvar intraepithelial neoplasia. The possibility that vulvar acanthosis with altered differentiation is a precursor to, or a risk factor for, vulvar carcinoma, merits further study.

Acanthosis Nigricans↗

PubMed1988

Invasive squamous cell carcinoma within verrucous carcinoma.

A case of invasive squamous cell carcinoma within a verrucous carcinoma is presented in order to illustrate the potential problem of underdiagnosis of these lesions. The epidemiology, natural history and histopathology of verrucous carcinoma, and features which distinguish it from invasive squamous cell carcinoma, are reviewed. Unless rigorous attention is paid to histologic detail, a focus of invasive squamous cell carcinoma may escape detection and radiation-induced anaplastic transformation may later be suspected.

Aged↗

PubMed1980

Verrucous lesions of the female genitalia. II. Verrucous carcinoma.

Verrucous carcinoma is a variant of squamous cell carcinoma that often presents as a large cauliflower-like lesion with locally destructive growth. A high index of suspicion on the part of the clinician and pathologist is needed for an accurate diagnosis since the pathologic findings may be benign on an individual cell basis or may even resemble those of a condyloma. Deep biopsy that includes the base of the lesion is needed for accurate histologic diagnosis, and the pathologist should be aware of the aggressive nature of the lesion. The treatment of choice is surgical, with wide local excision being sufficient in most cases. Radiotherapy often fails to eradicate the lesion and may even cause it to become more anaplastic.

Carcinoma, Papillary↗

PubMed1997

Comparative study of invasive squamous cell carcinoma and verrucous carcinoma of the oral cavity: expression of bcl-2, p53, and Her-2/neu, and indexes of cell turnover.

Significant clinical and biological differences are found between invasive squamous cell carcinoma (SCCA) and verrucous carcinoma (VC) of the oral cavity. The correct diagnosis of these tumors has important therapeutic implications. Immunoperoxidase stains for bcl-2, p53, and Her-2/neu, and in situ end-labeling of DNA to identify apoptosis were performed in eight VC and eight SCCA matched for age, sex, and stage. Marked differences were identified in the pattern of expression of oncogenes and the indexes of cell turnover in these two types of tumors. VC displayed minimal apoptosis in rare keratinizing cells (0 to 3%); p53-positive cells (4/8) and Ki-67 (8/8) were confined to the nuclei of the basal proliferating layers; and bcl-2 (4/8) was expressed only in the cytoplasm of rare tumor cells. In contrast, SCCA displayed higher apoptosis rates (5 to 10%), whereas p53- (5/8) and Ki-67- (8/8) positive nuclei were distributed randomly throughout the tumor. Very well differentiated areas in one SCCA case had a pattern of staining for p53 and Ki-67 similar to the one seen in VC. In SCCA bcl-2 showed patchy cytoplasmic staining (4/8) or strong cytoplasmic and nuclear positivity (2/8) in the less differentiated tumors. Her-2/neu was negative in all VC and SCCA cases. The different levels and patterns of gene expression and cell turnover between SCCA and VC undoubtedly correlate with the different biology and prognosis of these tumors.

Aged↗

PubMed1989

Carcinoma cuniculatum (verrucous carcinoma) of the foot.

A patient with carcinoma cuniculatum of the foot, an uncommon tumor, is presented. This tumor, also reported as verrucous carcinoma and epithelioma cuniculatum, is a low-grade, squamous cell carcinoma of the skin that rarely metastasizes. The highly keratinizing lesion has a locally destructive course, but with treatment by excision, it has a low recurrence rate.

Carcinoma, Papillary↗