Dermatologic Manifestations of Verrucous Carcinoma Follow-up
- Author: Bassam Zeina, MD, PhD; Chief Editor: William D James, MD more...
Further Outpatient Care
Verrucous carcinoma (VC) usually is cured with appropriate therapy. However, recurrence of cutaneous carcinoma with clear surgical margins has been reported. In addition, patients are at risk for developing additional verrucous carcinoma and squamous cell carcinoma and should be evaluated with skin examinations at 3- to 12-month intervals.
Prognosis
In most cases of verrucous carcinomas, regardless of the variant, the clinical outcome is rarely an aggressive course. Most patients with verrucous carcinoma have a good prognosis. Local verrucous carcinoma recurrence following definitive treatment is not uncommon. Regarding oral verrucous carcinoma, the reported recurrence rate ranges from 6-40%. If metastasis does occur, it is mainly at the regional lymph nodes.[8] There have been reports of metastases in distant sites, but this is considered rare. In long-standing lesions, occasional destruction of adjustment structures such as cartilage, tendons, and bones can occur. Patients with oral verrucous carcinoma may be at an increased risk of a second primary oral squamous cell carcinoma, which carries a poor prognosis.
Patient Education
Advise patients about the importance of receiving effective treatment for areas of chronic skin inflammation or trauma (eg, leg or decubitus ulcers) to prevent these problems from developing malignancies within them. Improved oral, genital, and perianal hygiene may help to prevent inflammatory conditions that predispose patients to verrucous carcinoma. Cessation of chewing tobacco use may help to prevent oral verrucous carcinoma.
For patient education resources, see the Cancer and Tumors Center and Warts Center, as well as Skin Cancer, Warts, and Skin Biopsy.
Ackerman LV. Verrucous carcinoma of the oral cavity. Surgery. Apr 1948;23(4):670-8. [Medline].
Aird I, Johnson HD, Lennox B, Stansfeld AG. Epithelioma cuniculatum: a variety of squamous carcinoma peculiar to the foot. Br J Surg. Nov 1954;42(173):245-50. [Medline].
Aroni K, Lazaris AC, Ioakim-Liossi A, Paraskevakou H, Davaris PS. Histological diagnosis of cutaneous "warty" carcinoma on a pre-existing HPV lesion. Acta Derm Venereol. Jul-Aug 2000;80(4):294-6. [Medline].
Mirbod SM, Ahing SI. Tobacco-associated lesions of the oral cavity: Part II. Malignant lesions. J Can Dent Assoc. Jun 2000;66(6):308-11. [Medline].
Terada T. Verrucous carcinoma of the skin: a report on 5 Japanese cases. Ann Diagn Pathol. Jun 2011;15(3):175-80. [Medline].
Hagiwara H, Kanazawa T, Ishikawa K, et al. Invasive verrucous carcinoma: a temporal bone histopathology report. Auris Nasus Larynx. Apr 2000;27(2):179-83. [Medline].
Grinspan D, Abulafia J. Oral florid papillomatosis (verrucous carcinoma). Int J Dermatol. Oct 1979;18(8):608-22. [Medline].
Walvekar RR, Chaukar DA, Deshpande MS, et al. Verrucous carcinoma of the oral cavity: A clinical and pathological study of 101 cases. Oral Oncol. Jan 2009;45(1):47-51. [Medline].
Depprich RA, Handschel JG, Fritzemeier CU, Engers R, Kubler NR. Hybrid verrucous carcinoma of the oral cavity: A challenge for the clinician and the pathologist. Oral Oncology EXTRA. 2006;42:85-90.
Castano E, Lopez-Rios F, Alvarez-Fernandez JG, Rodriguez-Peralto JL, Iglesias L. Verrucous carcinoma in association with hypertrophic lichen planus. Clin Exp Dermatol. Jan 1997;22(1):23-5. [Medline].
Warshaw EM, Templeton SF, Washington CV. Verrucous carcinoma occurring in a lesion of oral lichen planus. Cutis. Apr 2000;65(4):219-22. [Medline].
Levy A, Lebbe C. [Buschke-Löwenstein tumour: diagnosis and treatment]. Ann Urol (Paris). Jun 2006;40(3):175-8. [Medline].
Blackmore CC, Ratcliffe NR, Harris RD. Verrucous carcinoma of the bladder. Abdom Imaging. Sep-Oct 1995;20(5):480-2. [Medline].
Groeneveld AE. Verrucous carcinoma of the bladder. Br J Urol. Jul 1992;70(1):96-7. [Medline].
D'Aniello C, Grimaldi L, Meschino N, Brandi C, Andreassi A, Bosi B. Verrucous 'cuniculatum' carcinoma of the sacral region. Br J Dermatol. Aug 2000;143(2):459-60. [Medline].
Gallo A, Fiorella ML, Simonelli M, Rocca CD, de Vincentiis M. Carcinoma cuniculatum: verrucous carcinoma of the skin of the face. Otolaryngol Head Neck Surg. Oct 2005;133(4):640. [Medline].
Ho J, Diven DG, Butler PJ, Tyring SK. An ulcerating verrucous plaque on the foot. Verrucous carcinoma (epithelioma cuniculatum). Arch Dermatol. Apr 2000;136(4):547-8, 550-1. [Medline].
Kao GF, Graham JH, Helwig EB. Carcinoma cuniculatum (verrucous carcinoma of the skin): a clinicopathologic study of 46 cases with ultrastructural observations. Cancer. Jun 1 1982;49(11):2395-403. [Medline].
Kempe SA, Kreiser DZ. Epithelioma cuniculatum of the foot. Literature survey and case history. J Am Podiatry Assoc. Jul 1984;74(7):351-4. [Medline].
Pattee SF, Bordeaux J, Mahalingam M, Nitzan YB, Maloney ME. Verrucous carcinoma of the scalp. J Am Acad Dermatol. Mar 2007;56(3):506-7. [Medline].
Kuan YZ, Hsu HC, Kuo TT, Huang YH, Ho HC. Multiple verrucous carcinomas treated with acitretin. J Am Acad Dermatol. Feb 2007;56(2 Suppl):S29-32. [Medline].
Vandeweyer E, Sales F, Deraemaecker R. Cutaneous verrucous carcinoma. Br J Plast Surg. Mar 2001;54(2):168-70. [Medline].
Huang SH, Lockwood G, Irish J, et al. Truths and myths about radiotherapy for verrucous carcinoma of larynx. Int J Radiat Oncol Biol Phys. Mar 15 2009;73(4):1110-5. [Medline].
Witt RL, Wilson P. Missed opportunity for larynx preservation? Failure to distinguish verrucous and squamous cell carcinoma on microlaryngoscopy and biopsy. J Voice. Jan 2009;23(1):140-2. [Medline].
Shidara Y, Karube A, Watanabe M, et al. A case report: verrucous carcinoma of the endometrium--the difficulty of diagnosis, and a review of the literature. J Obstet Gynaecol Res. Jun 2000;26(3):189-92. [Medline].
Shiomori T, Udaka T, Nagatani G, et al. Association of verrucous carcinoma and inverted papilloma in the sinonasal tract. Auris Nasus Larynx. Jun 2007;34(2):281-5. [Medline].
Cosman BC, O'Grady TC, Pekarske S. Verrucous carcinoma arising in hidradenitis suppurativa. Int J Colorectal Dis. Nov 2000;15(5-6):342-6. [Medline].
Nasca MR, Innocenzi D, Micali G. Penile cancer among patients with genital lichen sclerosus. J Am Acad Dermatol. Dec 1999;41(6):911-4. [Medline].
Masih AS, Stoler MH, Farrow GM, Wooldridge TN, Johansson SL. Penile verrucous carcinoma: a clinicopathologic, human papillomavirus typing and flow cytometric analysis. Mod Pathol. Jan 1992;5(1):48-55. [Medline].
Miyamoto T, Sasaoka R, Hagari Y, Mihara M. Association of cutaneous verrucous carcinoma with human papillomavirus type 16. Br J Dermatol. Jan 1999;140(1):168-9. [Medline].
Abbas MA. Wide local excision for Buschke-Löwenstein tumor or circumferential carcinoma in situ. Tech Coloproctol. Sep 2011;15(3):313-8. [Medline].
Yeh CJ. Treatment of verrucous hyperplasia and verrucous carcinoma by shave excision and simple cryosurgery. Int J Oral Maxillofac Surg. Jun 2003;32(3):280-3. [Medline].
Alkalay R, Alcalay J, Shiri J. Plantar verrucous carcinoma treated with Mohs micrographic surgery: a case report and literature review. J Drugs Dermatol. Jan 2006;5(1):68-73. [Medline].
Muro Vidaurre I, Hernaez Manrique I, Sanz Jaka JP, Rekarte Barriola JA, Lluch Costa A. [Verrucous carcinoma of the penis: local excision with the Mohs micrographic technique]. Arch Esp Urol. Nov 1996;49(9):959-64. [Medline].
Padilla RS, Bailin PL, Howard WR, Dinner MI. Verrucous carcinoma of the skin and its management by Mohs' surgery. Plast Reconstr Surg. Mar 1984;73(3):442-7. [Medline].
Ishida CE, Ramos-e-Silva M. Cryosurgery in oral lesions. Int J Dermatol. Apr 1998;37(4):283-5. [Medline].
Ferlito A, Rinaldo A, Mannara GM. Is primary radiotherapy an appropriate option for the treatment of verrucous carcinoma of the head and neck?. J Laryngol Otol. Feb 1998;112(2):132-9. [Medline].
Foroudi F, Turner S. Verrucous scrotal carcinoma: a radioresponsive tumor. J Urol. Nov 1999;162(5):1694-5. [Medline].
Schwade JG, Wara WM, Dedo HH, Phillips TL. Radiotherapy for verrucous carcinoma. Radiology. Sep 1976;120(3):677-9. [Medline].
Nikkels AF, Thirion L, Quatresooz P, Piérard GE. Photodynamic therapy for cutaneous verrucous carcinoma. J Am Acad Dermatol. Sep 2007;57(3):516-9. [Medline].

