Skin - Nonmelanocytic tumors
Carcinoma (non-adnexal)
Verrucous carcinoma

Author: Ghassan Tranesh, M.D. (see Authors page)
Editor: Hong Qu, M.D.

Revised: 13 October 2016, last major update November 2014

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Verrucous carcinoma [title] skin

Cite this page: Verrucous carcinoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/skintumornonmelanocyticverrucousscc.html. Accessed October 18th, 2017.
Definition / general
  • Verrucous carcinoma describes a low grade squamous cell carcinoma affecting skin and mucosa with characteristic slow growth, minimal local invasion and only rare metastases
  • Suspect if a longstanding verrucous lesion is unresponsive to routine treatment (Indian Dermatol Online J 2014;5:218)
Sites
  • Most cases (90%) are found on the feet (Indian Dermatol Online J 2014;5:218)
  • Pathophysiology
    • Risk factors include chronic inflammation or irritation, human papillomavirus (HPV) infection
    • For oral cavity, risk factors also include betel nut chewing, smoking,
    Case reports
    Treatment
    • Surgical excision, cryosurgery, carbon dioxide laser, chemotherapy, intralesional or iontophoretic methods, photodynamics therapy, systemic retinoid therapy, radiotherapy
    Clinical images

    Images hosted on other servers:

    Finger tumors

    Vulvar tumor

    Heel tumor

    Gross description
    • Ulcerating, fungating or polypoid mass with sinus tracts opening onto skin surface
    Microscopic (histologic) description
    • Epidermis with hyperkeratosis, papillomatosis, hypergranulosis, acanthosis
    • Rete ridges are bulbous with "bulldozing" pattern
    • Deeper biopsy shows broad bands of epidermal proliferation with parakeratotic centers; bases of proliferation are large and bulbous and invade deep dermis in a pushing manner
    • Minimal atypia (Indian Dermatol Online J 2014;5:218)
    Microscopic (histologic) images

    Images hosted on Flickr:

    Courtesy of Dr. Asmaa Gaber Abdou



    Images hosted on other servers:

    Low grade tumor with broad pushing border



    Vulva

    Heel

    Extravasated erythrocytes

    Keratin pearls

    Positive stains
    • HPV (frequently, usually 16, 6, 11)
    Differential diagnosis
    • Benign keratoses
    • Cysts
    Additional references