Histologic Variants of Squamous Cell Carcinoma of the Skin

Margaret H. Rinker, MD; Neil A. Fenske, MD; Leigh Ann Scalf, MD, and L. Frank Glass, MD, Division of Dermatology and Cutaneous Surgery, Department of Internal Medicine at the University of South Florida, Tampa, Fla.

Cancer Control. 2001;8(4) 

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Verrucous Carcinoma

Verrucous carcinoma is a low-grade variant of SCC with little potential for distant metastases. However, it has the potential to cause local destruction. The term"verrucous carcinoma" was first used by Ackerman[20] in 1948 to describe a carcinoma of the oral cavity. In 1954, Aird et al[21] described a histologically similar tumor on the plantar surface, which they named carcinoma cuniculatum.A similar tumor of the anogenital region, named the giant condyloma of Buschke and Löwenstein,[22] had already been described in 1925.In 1960, Rock and Fisher,[23] probably not aware of the already-described verrucous carcinoma by Ackerman,suggested the term oral florid papillomatosis to describe vegetating verrucous lesions in the mouth that simulated carcinoma. It is now thought that all three tumors -- oral florid papillomatosis, giant condyloma,and carcinoma cuniculatum -- represent verrucous carcinomas. In addition to occurring in the oral cavity, genital area, and the plantar surface, verrucous carcinoma may occur anywhere on the skin.

Although the pathogeneses of verrucous carcinoma remains unknown, HPV, chronic irritation,and chemicals have been implicated.The diagnosis of this type of SCC may be particularly challenging due to its bland histologic features.A superficial biopsy is usually not sufficient to distinguish this tumor from verruca vulgaris, KAs,and pseudoepitheliomatous hyperplasia.Therefore, obtaining a deep incisional biopsy is recommended.

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