Larynx, hypopharynx & trachea
Squamous cell carcinoma
Verrucous carcinoma
Author: Nat Pernick, M.D.
Last author update: 1 November 2013
Last staff update: 21 November 2024 (update in progress)
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Verrucous carcinoma larynx
Table of Contents
Definition / general | Treatment | Gross description | Microscopic (histologic) description | Differential diagnosisCite this page: Pernick N. Verrucous carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/larynxverrucous.html. Accessed November 27th, 2024.
Definition / general
- 1 - 4% of laryngeal cancers
- Has cytologic and architectural features normally associated with a reactive process but with ability to invade normal tissue
- Locally destructive but almost never metastasizes; associated cervical adenopathy may be reactive and not metastatic disease
- Usually men in 50s to 60s; associated with tobacco smoking or chewing
- Occurs anywhere in upper aerodigestive tract
- 5 year survival 78% (better after surgery than radiation therapy)
- May coexist with conventional squamous cell carcinoma (if both present, must treat more aggressive component)
- HPV negative
- Difficult diagnosis to make, particularly from biopsies
Treatment
- Surgery; radiation not recommended in general since ineffective and may cause anaplastic transformation
Gross description
- Large, white-tan exophytic tumor fixed to normal structures
- Up to 10 cm; attached by broad base
Microscopic (histologic) description
- Invasive cancer with well differentiated squamous epithelium that lacks features of squamous cell carcinoma
- By definition has no dysplastic features above basal zone; uniform cells without atypia or mitotic figures
- Marked surface keratinization (church spire keratosis), broad rete pegs with pushing but not an infiltrative margin
- May have prominent lymphoplasmacytic and histiocytic infiltrate
Differential diagnosis
