Which microscopic pathologic findings are characteristic of verrucous squamous cell carcinoma of the urinary bladder?

Updated: Jun 11, 2019
  • Author: Muhammad T Idrees, MD; Chief Editor: Liang Cheng, MD  more...
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Answer

Verrucous squamous cell carcinoma is a rare variant of squamous cell carcinoma of the bladder, accounting for less than 5% of cases. [34, 35] Most cases are associated with S haematobium infection; few cases have been reported from nonendemic areas. The tumor has an indolent growth pattern and spreads by direct extension. It does not metastasize, although it may develop foci of invasive squamous cell carcinoma. [36]

Grossly, the tumor is a warty, exophytic mass that projects into the bladder lumen.

Microscopically, it appears as a prominent papillary mass with acanthosis. The tumor grows in bulbous fronds of well-differentiated, acanthotic epithelium. There is minimal atypia and pushing margin without increased mitoses.

Verrucous squamous cell carcinoma may focally resemble condyloma and has been reported to be associated with human papillomavirus (HPV); however, no firm link to HPV infection has been established. [37, 38] Generally, verrucous carcinoma is considered to pose a low risk for progression, but the degree of risk with bladder tumors is difficult to establish due to the relatively small number of cases.


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