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ABSTRACT Objective Materials and Methods Results Conclusion Proliferative verrucous leukoplakia (PVL) is an oral potentially malignant disorder. Forms that affect only one tissue are poorly studied, especially the exclusively gingival PVL (gPVL), which may have a more increased malignant transformation potential. The aim of the present study was to characterise the gPVL and its risk of malignant transformation to better raise awareness of this specific disorder.The systematic review was performed on PubMed, Scopus, Web of Science and Google Scholar. Only articles reporting primary studies, case reports and case series were included. The meta‐analysis was performed for the cancer prevalence, proportion of smokers, age and sex ratio, recurrences of gPVL and mortality.A total of 1298 studies were assessed for eligibility by reading titles and abstracts. Fourteen original articles were included with a total of 58 patients. The malignant transformation rate of gPVL was 47.75%. The mortality was 5.84%. The mean follow‐up duration before malignant transformation was 3 years.gPVL seems to have a faster malignant transformation rate than the other forms of PVL. Finding anatomo‐pathological or genetic markers could be a line of research to predict gPVL malignant transformation and improve its diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Perineal verrucous carcinoma is a rare variant of squamous cell carcinoma that is mainly treated with surgical excision. In this case report, we present a 58-year-old man with human immunodeficiency virus who presented with an extraordinarily large perineal mass that was ultimately found to be verrucous carcinoma in association with giant condyloma acuminata. He was treated with a wide local excision followed by staged abdominoperineal resection and fasciocutaneous flap reconstruction. In the post-operative course, the patient developed relatively short interval recurrence which was successfully managed with salvage radiotherapy. He is now post-radiation without evidence of recurrence. [ABSTRACT FROM AUTHOR]

Background: Cancer associated fibroblasts are heterogenous activated fibroblasts that form the central component of the tumor microenvironment. These cells influence the behavior of the tumor by activating various signaling pathways and initiating epithelial mesenchymal transition. CAFs have been reported in oral squamous cell carcinomas (OSCC), however, very few studies have evaluated the role of CAFs in different variants of OSCC. The aim of this study was to compare the role of CAFs in conventional OSCC and different variants of OSCCs. Materials and methods: Eight each of well differentiated, moderately differentiated and poorly differentiated OSCC, 5 each of verrucous carcinoma and verrucous carcinoma turning into OSCC, three each of spindle cell carcinoma, basaloid OSCC and OSCC with clear cell differentiation and 2 cases of papillary OSCC were retrieved, and immunohistochemistry was performed with α-SMA to identify and evaluate the CAFs. Kaplan Meier analysis was carried out to evaluate the overall survival of the patients. Results: Progressive increase in the CAF immunostaining was noted from papillary squamous cell carcinoma [mean - 1] to basaloid squamous cell carcinoma [1.6 ± 0.5] to spindle cell carcinoma and squamous cell carcinoma with clear cell changes [2.6 ± 0.5] (p = 0.00 - statistically significant). Patients with abundant CAF expression showed lesser survival rate when compared to patients with scanty or focal CAF immunohistochemical staining. Conclusion: Increased CAF immunoexpression was noted in PDSCCs, VCs turning into SCC, OSCC with clear cell changes and spindle cell carcinoma. This highlights the aggressive nature of these tumors. Screening these tumor for the presence of CAFs will help in treatment planning and will aid in treatment planning and survival analysis.

Verrucous carcinoma, a well-differentiated variant of squamous cell carcinoma with low-grade malignancy, is often associated with localized human papillomavirus (HPV) infection and excessive penile foreskin. We report a 45-year-old male who presented with a verrucous plaque on the glans penis for over four months, along with itching. Examination revealed a verrucous, erosive lesion with a cauliflower-like surface, firm texture, and irregular shape, accompanied by pain, bleeding, and a foul odor. Syphilis and HIV tests were negative, and a biopsy confirmed verrucous carcinoma.The patient underwent initial circumcision at a local hospital, but persistent lesions raised concerns about further surgery impairing sexual function and anatomical integrity. To preserve both anatomical and functional integrity, the patient opted for Hematoporphyrin Derivative-Photodynamic Therapy (HpD-PDT). Post-treatment, the lesions regressed, and after four years of follow-up, there was no scarring or recurrence. The clinical outcome was favorable with complete lesion regression.We propose that PDT is a viable treatment option for penile verrucous carcinoma, offering advantages over traditional methods in terms of function preservation and cosmetic outcomes.

Background: Oral squamous cell carcinoma (OSCC) is a serious health disease that can lead to a reduced quality of life or even death. It ranks sixth in terms of cancer expansion. It is one of India's primary causes of natural death. In OSCC such potentially malignant Disorders (PMDs) are precancerous lesions with such a high risk of progression. Tumor angiogenesis is a one of the basic biomarkers that may influence the proliferation of a precancerous lesion into the cancerous lesion. Tropomyosin receptor kinase B (TrkB), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF) also play important roles in carcinogenesis by promoting angiogenesis. The construction of new vessels of blood from existing vasculature is referred as angiogenesis. Aim of the Study: To get deep insights of immunohistochemistry expression of VEGF, BDNF, and TRKB in oral epithelial dysplasia (OED), verrucous carcinoma (VC), and OSCC. Material and Methods: The study included 100 formalin-fixed paraffin-embedded tissue blocks from 20 cases of OED, 20 cases of VC, and 60 cases of OSCC [20 cases of well-differentiated oral squamous cell carcinoma (WD-OSCC), 20 cases of moderately differentiated oral squamous cell carcinoma (MD-OSCC), and 20 cases of poorly differentiated oral squamous cell carcinoma (PD-OSCC). The staining intensity and distribution of VEGF, BNDF, and TrkB were examined and statistically analyzed using analysis of variance (ANOVA), post hoc Bonferroni test, independent t-test, Pearson's Chi-square test, and Pearson's correlation coefficient test. Results: The immunoexpression of VEGF, BDNF, and TrkB was found to be elevated in the order of OEDs, VC, and OSCC. The percentage of positive was highest in PD-OSCC, followed by MD-OSCC and WD-OSCC. Conclusion: Based on our findings, angiogenesis plays a significant role in tumor growth and metastasis. A substantial relationship was discovered between VEGF, BDNF, TrkB expression, and increases in vascularity throughout the transition from OEDs to VCs and OSCCs. [ABSTRACT FROM AUTHOR]

Oral verrucous carcinoma (OVC) and proliferative verrucous leukoplakia (PVL) share similar histological characteristics and may have a common origin. When they appear simultaneously, the risk of malignant transformation in PVL increases. In elderly patients with both conditions, a safe, effective, simple, and minimally invasive treatment is preferable. Photodynamic therapy (PDT), a non-invasive treatment, utilizes specific wavelengths of light to activate photosensitizers, generating reactive oxygen species that selectively target malignant tissues with cytotoxic effects. This case report describes an elderly patient with coexisting extensive leukoplakia, PVL, and OVC, who achieved complete remission with no recurrence at 10 months following PDT. The treatment resulted in a satisfactory clinical outcome, preserving both the appearance and function of the oral cavity.

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma (SCC) characterized by its histological presentation as a low-grade tumor with no potential for metastasis, setting it apart from invasive SCC. However, distinguishing VC from its benign counterpart, verrucous hyperplasia (VH), is challenging due to their clinical and morphological similarities. Despite the importance of accurate diagnosis for determining treatment strategies, diagnosis of VH and VC relied only on lesion recurrence after resection. To address this challenge, we generated RNA profiling data from tissue samples of VH and VC patients to identify novel diagnostic markers. We analyzed differentially expressed (DE) mRNA and long non-coding RNA (lncRNA) in tissue samples from VH and VC patients. Additionally, ChIP-X Enrichment Analysis 3 (ChEA3) was conducted to identify the top five transcription factors potentially regulating the expression of DE mRNAs in VH and VC. Our analysis of mRNA and lncRNA expression profiles in VH and VC provides insights into the underlying molecular characteristics of these diseases and offers potential new diagnostic markers. The identification of specific DE genes and lncRNAs may enable clinicians to more accurately differentiate between VH and VC, leading to better treatment choices.

Introduction: Verrucous Carcinoma (VC), a well-differentiated Squamous Cell Carcinoma (SCC), commonly presents in the oral cavity, accounting for 2-16% of oral carcinomas. Though rare, it poses a challenge in establishing a pathological diagnosis, even in adequate biopsies, as 20% of Oral Cavity Verrucous Carcinoma (OVC) contains concomitant SCC. VC is primarily treated by surgery, similar to oral SCC. The role of neck dissection in oral SCC is well-established, but there is limited data on VC. Aim: To evaluate the role of neck dissection in the management of OVC. It also aimed to evaluate the clinicopathological demographics of OVC and identify predictors for survival outcomes. Materials and Methods: A retrospective cohort study was conducted using medical records of 2312 patients with oral carcinoma treated from January 2010 to December 2020 at Department of Surgical Oncology, Malabar Cancer Centre, Kannur, Thalassery, Kerala, India, a tertiary cancer centre under the Government of Kerala. Among 116 patients identified with VC, 49 patients met the inclusion criteria. The collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0. The primary outcomes were overall survival rate and disease-free survival rate. Kaplan-Meier curves were constructed based on the survival data and compared using the log-rank test. Results: The mean age of the entire population was 62.8 years, with an age range of 40-90 years. Among the 2312 patients who underwent surgery for oral carcinoma, 49 (2.11%) patients were diagnosed with VC based on the final histopathology report. The majority of patients were diagnosed with early-stage disease on histopathological examination 36/49 (73.5%). A total of 34 patients received neck dissections, of which 13 patients (38.3%) had palpable nodes on presentation. All patients were node negative (PN0). On univariate analysis, neck dissection was not found to be a predictor of mortality or locoregional recurrence. There was no significant difference in overall survival rate (p=0.160) or disease-free survival rate (p=0.67) when comparing patients who underwent primary resection with neck dissection to those whose necks were kept under observation. Conclusion: The OVC has an excellent prognosis, and surgery remains the mainstay of treatment. The decision on neck dissection and the extent of neck dissection should be judiciously made based on the surgical approach and the procedure’s morbidity.

Verrucous carcinoma is a rare, low-grade variant of well-differentiated squamous cell carcinoma. Plantar verrucous carcinoma presents as a slow-growing, exophytic, verrucous plaque on weight bearing areas of the foot. Verrucous carcinomas have low metastatic potential, but are high risk for local invasion. We describe a patient with a 20-year history of a slowly growing, ulcerated, verrucous plaque on the sole of the left foot that was erroneously treated for years as verruca plantaris and was eventually diagnosed as invasive verrucous carcinoma. Verrucous carcinomas are a diagnostic challenge due to clinical and histopathologic mimicry of benign lesions. Mohs micrographic surgery should be employed to allow the ability to intraoperatively assess tumor margins while excising the minimal amount of necessary tissue. It is important for clinicians to recognize the characteristics and accurately diagnose verrucous carcinomas. Delays in treatment may require more extensive dissection or amputation. [ABSTRACT FROM AUTHOR]

Introduction: Verrucous Carcinoma (VC), a well-differentiated Squamous Cell Carcinoma (SCC), commonly presents in the oral cavity, accounting for 2-16% of oral carcinomas. Though rare, it poses a challenge in establishing a pathological diagnosis, even in adequate biopsies, as 20% of Oral Cavity Verrucous Carcinoma (OVC) contains concomitant SCC. VC is primarily treated by surgery, similar to oral SCC. The role of neck dissection in oral SCC is well-established, but there is limited data on VC. Aim: To evaluate the role of neck dissection in the management of OVC. It also aimed to evaluate the clinicopathological demographics of OVC and identify predictors for survival outcomes. Materials and Methods: A retrospective cohort study was conducted using medical records of 2312 patients with oral carcinoma treated from January 2010 to December 2020 at Department of Surgical Oncology, Malabar Cancer Centre, Kannur, Thalassery, Kerala, India, a tertiary cancer centre under the Government of Kerala. Among 116 patients identified with VC, 49 patients met the inclusion criteria. The collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0. The primary outcomes were overall survival rate and disease-free survival rate. Kaplan-Meier curves were constructed based on the survival data and compared using the log-rank test. Results: The mean age of the entire population was 62.8 years, with an age range of 40-90 years. Among the 2312 patients who underwent surgery for oral carcinoma, 49 (2.11%) patients were diagnosed with VC based on the final histopathology report. The majority of patients were diagnosed with early-stage disease on histopathological examination 36/49 (73.5%). A total of 34 patients received neck dissections, of which 13 patients (38.3%) had palpable nodes on presentation. All patients were node negative (PN0). On univariate analysis, neck dissection was not found to be a predictor of mortality or locoregional recurrence. There was no significant difference in overall survival rate (p=0.160) or disease-free survival rate (p=0.67) when comparing patients who underwent primary resection with neck dissection to those whose necks were kept under observation. Conclusion: The OVC has an excellent prognosis, and surgery remains the mainstay of treatment. The decision on neck dissection and the extent of neck dissection should be judiciously made based on the surgical approach and the procedure’s morbidity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the survival benefit of elective neck dissection (END) over neck observation in cT1‐4 N0M0 head and neck verrucous carcinoma (HNVC). Study Design: Retrospective cohort study. Setting: The 2006 to 2017 National Cancer Database. Methods: Patients with surgically resected cT1‐4 N0M0 HNVC were selected. Linear, binary logistic, Kaplan‐Meier, and Cox proportional hazards regression models were utilized. Results: Of 1015 patients satisfying inclusion criteria, 223 (22.0%) underwent END. The majority of patients were male (55.4%) and white (91.0%) with disease of the oral cavity (67.6%) classified as low grade (90.0%) and cT1‐2 (81.8%). The minority of ENDs (4.0%) detected occult nodal metastases. The rate of END increased from 2006 to 2017 for both cT1‐2 (16.3% vs 22.0%, p =.126, R2 = 0.405) and cT3‐4 (41.7% vs 70.0%, p =.424, R2 = 0.232) disease but these trends were not statistically significant. Independent predictors of undergoing END included treatment at an academic facility (adjusted odds ratio [aOR]: 1.75, 95% confidence interval [CI]: 1.19‐2.55), cT3‐4 disease (aOR: 3.31, 95% CI: 2.16‐5.07), and tumor diameter (aOR: 1.09, 95% CI: 1.01‐1.19) (p < 0.05). The 5‐year overall survival (OS) of patients treated with and without END was 71.3% and 70.6%, respectively (p =.661). END did not significantly reduce the 5‐year hazard of death (adjusted hazard ratio: 1.25, 95% CI: 0.91‐1.71, p =.172). END did not significantly improve 5‐year OS in univariate and multivariate analyses stratified by several patient, facility, tumor, and treatment characteristics. Conclusion: END does not confer an appreciable survival benefit in HNVC, even after stratifying univariate and multivariate analyses by several patient, facility, tumor, and treatment characteristics. Level of Evidence: Level 4. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is an uncommon, recurrent, inflammatory skin illness of the apocrine glands, with a questionable etiology. The disease is associated with a multitude of comorbidities, of which the appearance of malignancy is the most important. Squamous cell carcinoma is considered the most frequent malignancy that can appear in HS. A case report of a 72 years-old male is presented, who suffered over 40 years from persistent, extensive hidradenitis suppurativa in stage Hurley III, on the buttocks and perianal region, who recently presented two verrucous semi-consistent, skin-colored tumors on the right buttock. The biopsy and histopathological exam confirmed a verrucous type of squamous cell carcinoma. There are about 100 reported clinical cases of squamous cell carcinoma complicating hidradenitis suppurativa in the literature, but only a few describe a verrucous carcinoma as a clinical form. The particularity of the case is the rare appearance of multiple verrucous types of squamous cell carcinomas in a male patient, in Hurley Stage III, with a long HS disease duration, appearing on the perianal/gluteal region, being the first case report in our country. We suggest that a tumor screening should be done for all the patients with HS who have these risks.

Verrucous carcinoma is a rare urological malignancy that primarily affects the penile area, with the upper urinary tract, particularly the ureter, being less common. The literature on verrucous carcinoma of the ureter is limited due to its rarity. There have been reports of verrucous carcinoma including oral verrucous carcinoma, cutaneous verrucous carcinoma, kidney verrucous carcinoma, and other types of verrucous carcinoma. We presented the world's first case of ureter verrucous carcinoma. [ABSTRACT FROM AUTHOR]

Objective: To illustrate the clinicopathological comparison of carcinoma cuniculatum (CC), verrucous carcinoma (VC) and microinvasive squamous cell carcinoma (MISCC) and to compare the immunoexpression Ki67, p53 & c-myc in these entites. Material and methods: Clinical and histopathological parameters observed in total 67 cases (12 cases of CC, 22 cases of VC and 27 cases of MISCC). Ki67 & p53 labelling index and c-myc immunoexpression (localization of stain (1: cytoplasmic; 2: nuclear; 3: both), intensity of stain (1: mild; 2: moderate; 3: strong) and distribution of stain in epithelium (1: basal third; 2: up to middle third; 3: up to upper third; 4: invasive islands)). Results: CC predominantly showed keratin filled crypts, keratin microabscess, microsequestra formation and lymphocytic exocytosis. VC showed broad pushing invasive front, parakeratin plugging along with verrucous projections. Irregular infiltrating rete ridge pattern and severe cytological atypia were findings of MISCC. Ki67 LI was 12.70 % in CC, 23.34 % in VC and 28.27 % in MISCC. p53 LI was 44.167 % in CC, 30.18 % in VC and 29.51 % in MISCC. Ki67 LI showed statistically significance difference between CC and MISCC. Moderate to strong cytoplasmic immunoexpression was found in epithelium as well as in invasive islands of MISCC compared to CC and VC. Conclusion: CC shows endophytic epithelium proliferation with mild to moderate dysplasia and no definite invasive front in contrast to VC. High p53 in CC basal cells correlate with more endophytic epithelial proliferation. Significant high Ki67 LI in invasive islands of MISCC supports its aggressive nature. p53, Ki67 and c-myc panel may be helpful as an adjunct in difficult cases with poorly oriented specimens.

Verrucous carcinoma is a low-grade variant of squamous cell carcinoma with specific morphologic, cytokinetic and clinical features. Despite low mitotic activity and slow growth, it can infiltrate adjacent tissues in advanced stages but does not metastasize. The most frequently affected site is the oral cavity. The following article provides latest updates in the etiology, clinical presentation, diagnostics and treatment options in oral verrucous carcinoma and discusses the existing dilemmas linked to this unique malignancy.

Squamous cell carcinoma is the most common type of oral cancer that shows certain tissue changes. Laminin-5γ2 is a protein that plays a central role in migration of the neoplastic cells during tumor invasion. Expression of this protein in cells and stroma adjacent to tumor can confirm the cellular invasion. The aim of this study was to evaluate stroma in verrucous carcinoma and squamous cell carcinoma of the mouth using two markers α SMA and laminin 5 gamma 2.Materials & Methods:In this retrospective descriptive-analytical study, 60 samples were selected with the diagnosis of squamous cell carcinoma and verrucous oral carcinoma. Then, two markers of α SMA and laminin 5 gamma 2 were examined in epithelium and mesenchymal stroma by immunohistochemistry. The vasculature was used as a positive immunoreactivity control for alpha-smooth muscle and the normal mucosa was used to control the positive immunoreactivity of laminin 5 gamma 2. The results were analyzed using Chi-square and Spearman correlation tests (α = 0.05).Results:Out of 31 SCC samples, 80.6% showed laminin 5 gamma 2 and 90.3% showed alpha smooth and out of 9 samples of varocus carcinoma, 66.7% showed laminin 5 gamma 2 and 77.8% showed alpha smooth actin.The higher the positive percentage of laminin, the higher the percentage of positive α SMA.Conclusion:Expression of alpha smooth muscle actin and lamminin5gamma2 was significantly higher in oral squamous cell carcinoma and there exists a correlation between expression of alpha smooth muscle actin and the increase in myofibroblaststakes place during the carcinogenesis process

We describe a unique presentation of a cervical verrucous carcinoma (VC) associated with ichthyosis of the uterine cavity in an 80-year old woman. Areas of transition from a giant condyloma (GC) were present in the VC. This paper also includes a review of the relevant literature. VC of the cervix is an uncommon malignancy, and transition of a GC to VC is an interesting finding, confuting the theory that they represent distinct entities, with different risk factors. Differently from GC, VC is considered to be causally related to HPV in a minority of instances. Our results of p16 immunohistochemistry, the surrogate marker of high-risk human papillomavirus (HPV) infection, appear to speak against the causal role of HPV in the pathogenesis of VC. Ichthyosis uteri may occasionally be associated with a cervical or endometrial malignancy; however, we are not aware of any patient showing VC, GC and ichthyosis uteri at the same time. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Well‐differentiated variant of squamous cell carcinoma. Slow growing, exophytic, cauliflower‐like growth easily confused with a viral wart. Cutaneous, anogenital, and oral variant exist. Risk factors for oral variant include alcohol and smoking. Histopathologically exhibits lobules with a pushing margin and blunt borders. Verrucous carcinoma (VC) is a low‐grade variant of squamous cell carcinoma with specific clinicopathologic features and good prognosis when affecting skin. We report the case VC of lip in a‐70‐year‐old lady. She underwent surgical excision with excellent outcomes. A brief review of the literature is provided. [ABSTRACT FROM AUTHOR]

A 74-year-old transgender female presented with urinary difficulty and a painful lesion at her neo-vagina, 47 years after undergoing gender-affirming vaginoplasty. Initial biopsy reported Low-Grade Squamous Intraepithelial Lesion (LGSIL), while MRI revealed no inguinal or pelvic lymphadenopathy. Patient underwent partial neo-vaginectomy with wide local excision and formal urethroplasty. Pathology revealed verrucous carcinoma of the neovagina, a rare neoplasm in transgender female patients. This case highlights the importance of considering squamous cell carcinoma in the differential diagnosis of patients presenting lesions at neo-vagina and the need of screening methods for early detection of such neoplasms.

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma. VC is histologically a benign tumor, but it grows significantly and eventually forms a huge mass. Many different treatments are known, but the first-line treatment is surgical resection. VC has strong local infiltration and frequently recurs, making its local control very difficult in unresectable cases. We present a rare case of VC that could be treated with combined radiotherapy and Mohs’ chemosurgery, as a new option for unresectable VC.

Introduction: Deletion or mutation of tumor suppressor genes plays a significant role in cancer development. Mutation of the p53 tumor suppressor gene is the most common genetic alteration associated with oral cancer. The aim of this study was to compare the expression of p53 protein in oral squamous cell carcinoma and verrucous carcinoma. Methodology: Immunohistochemical analysis of p53 was done using monoclonal anti- p53, clone BP53-12 antibody (SIGMA, USA); immune-stained cells were counted and intensity of immune-staining in nucleus was noted. Results: Positive immunoreactivity for p53 oncoprotein was seen in 70.4% oral squamous cell carcinoma and 71% cases of verrucous carcinoma. Conclusion: No statistical significance was seen between the number of positive staining cases and staining intensity of oral squamous cell carcinoma and verrucous carcinoma. However, statistical significance was observed on quantitative analysis between oral squamous cell carcinoma and verrucous carcinoma.

Key Clinical Message Well‐differentiated variant of squamous cell carcinoma. Slow growing, exophytic, cauliflower‐like growth easily confused with a viral wart. Cutaneous, anogenital, and oral variant exist. Risk factors for oral variant include alcohol and smoking. Histopathologically exhibits lobules with a pushing margin and blunt borders. Abstract Verrucous carcinoma (VC) is a low‐grade variant of squamous cell carcinoma with specific clinicopathologic features and good prognosis when affecting skin. We report the case VC of lip in a‐70‐year‐old lady. She underwent surgical excision with excellent outcomes. A brief review of the literature is provided.

Verrucous carcinoma is a rare, low grade variant of squamous cell carcinoma that rarely metastasizes but tends to display aggressive local behavior. Wide local excision is the most common treatment, but has high rates of local recurrence, ranging from 19 to 75% in the literature. The cases of verrucous carcinoma treated with Mohs micrographic surgery in the literature, as well as a previously unpublished case is summarized. PubMed was searched for terms related to verrucous carcinoma and Mohs micrographic surgery, and articles reporting cases of verrucous carcinoma treated with Mohs were reviewed and summarized. A previously unpublished case treated at our institution was also reported. Thirty-eight cases of verrucous carcinoma treated with Mohs surgery were analyzed. The average age of patients was 52.1, and 50% were male. The most common sites were the foot (47%) and the anogenital region (34%). Lesion duration ranged from 0.17 to 40 years with a mean of 4.8 years, and tumor diameter ranged from 1 to 10 cm with a mean of 4.6 cm. The local recurrence rate following Mohs was 16%, with nodal metastasis occurring in 3% and no cases of distant metastasis. As verrucous carcinoma demonstrates locally aggressive behavior and a high risk of local recurrence, Mohs micrographic surgery should be considered as first line treatment. Further research directly comparing wide local excision to Mohs surgery is needed. [ABSTRACT FROM AUTHOR]

Abstract Background Verrucous carcinoma of the esophagus (VCE) is a rare tumor that is difficult to diagnose. In most cases, biopsies show nonspecific inflammatory and hyperkeratotic changes and do not show malignant findings. Most VCEs are slowly growing, locally advanced tumors with few metastases. Treatments for VCE are the same as for normal esophageal cancer, involving combined chemotherapy, surgical resection, and radiation therapy. However, it has been reported that VCE has a poor response to radiation or chemoradiotherapy (CRT). A case of VCE with complete response (CR) after CRT is presented. Case presentation A 70-year-old man was found to have white, irregular esophageal mucosa 4 years earlier. He had been followed up as an outpatient as having candidal esophagitis. However, his tumor grew gradually, and biopsy was performed by endoscopic mucosal resection (EMR). He was finally diagnosed with VCE. He had no metastases to distant organs, but some lymph node metastases were suspected. The tumor invaded his left bronchus. The esophagostomy and gastrostomy were constructed as emergent procedures. The patient then underwent definitive CRT. 4 weeks after the end of CRT, two-stage esophagectomy was performed. First, he underwent esophagectomy with thoracic lymph node dissection. A latissimus dorsi flap was patched to the bronchus after primary suture of the hole. 6 weeks later, reconstruction of the gastric tube was performed through the antethoracic route. The pathological findings showed CR to CRT, with no proliferative cancer cells in the specimen. The patient has had no recurrence for three and half years after the resection. Conclusions We presented a locally advanced VCE that achieved CR to CRT. In cases that have some difficulty for local resection, CRT might be an appropriate treatment for VCE.

Abstract Background Liposarcoma is one of the most common soft tissue sarcomas, but is extremely rarely found in the esophagus. There have been no reports of esophageal liposarcoma together with superficial carcinoma of the esophagus. Here, we report a patient who underwent complete resection of esophageal liposarcoma with carcinoma via a cervical approach. Case presentation A 66-year-old man was diagnosed with an esophageal tumor 11 years ago, but he left it untreated. He presented to our hospital with progressive dysphagia and appetite loss since the previous year. Esophagogastroduodenoscopy (EGD) showed a large pedunculated submucosal tumor (SMT) originating at the esophageal entrance, extending to the gastroesophageal junction. Additionally, there was a superficial carcinoma on the surface of the SMT, 30 cm from the incisor teeth. Three-dimensional computed tomography (3D-CT) showed a giant elongated intraluminal tumor extending downwards from the cervical esophagus. We diagnosed a giant esophageal polyp accompanied by a superficial carcinoma and performed tumor resection via a cervical approach. The excised specimen consisted of a 23.0 × 8.5 cm polypoid mass. The final diagnosis by histopathological and immunohistochemical examination was well-differentiated liposarcoma and esophageal squamous cell carcinoma. He was discharged on postoperative day 14 with drastic improvement in his swallowing ability. Conclusion We reported an extremely rare case of esophageal liposarcoma together with esophageal squamous cell carcinoma that was successfully resected through a small cervical incision.

To further characterize the clinicopathologic features of oral verrucous carcinoma.In accordance with PRISMA guidelines, a systematic review of the Medline, Web of Science, Embase, and Cochrane databases was performed in search of articles evaluating clinicopathologic features of oral verrucous carcinoma. Primary outcomes of interest included tumor subsites, T-staging, rates of cervical lymph node metastases, rates of distant metastases, 5-year survival (overall, disease-free, or disease-specific), and recurrence rates. Meta-analysis was performed using a random effects model.Nineteen articles with a total of 1458 subjects were ultimately included in the analysis. There were 17 studies with a total of 1353 patients reporting verrucous carcinoma subsites and the buccal mucosa (59.2%, 55.1%-63.3%) (I2 = 98.1%) had the highest incidence of involvement. There were 10 papers with 277 patients reporting on rates of cervical lymph node metastases from surgical pathology yielding a pooled rate of 0% (0%-2.3%) (I2 = 1%). There were 14 studies with a collective 712 patients commenting on rates of distant metastases and collectively, none were reported, yielding a pooled rate of 0% (0%-0%) (I2 = 0%). Five year survival data was generally favorable relative to oral squamous cell carcinoma but was insufficient for meta-analysis.An international collection of evidence supports that pure oral verrucous carcinoma is a relatively indolent, non-metastasizing malignancy associated with areca nut consumption. A reliance on traditional squamous cell carcinoma staging and treatment algorithms for verrucous carcinoma patients can predispose to overtreatment. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma (SCC) is the most common histological type of laryngeal cancer. Several variants of SCC have been reported. However, how these variants differ from conventional SCC and how they should be treated remain to be elucidated. To compare the prognosis of early-stage glottic cancer among SCC variants We obtained data from 12471 cases using the Surveillance, Epidemiology, and End Results database. Disease-specific survival (DSS) and overall survival (OS) rates were estimated using the Kaplan–Meier method. A Cox proportional hazard model was used to estimate hazard ratios (HRs) according to the variants. HRs for DSS and OS compared with well-differentiated SCC were 3.83 and 3.48 for adenosquamous, 1.42 and 1.42 for basaloid, 1.14 and 1.17 for papillary, 0.85 and 0.94 for spindle, and 0.81 and 1.00 for verrucous SCC. The difference in DSS among the treatment modalities was significant in conventional and papillary SCC (p <.001 and p =.032, respectively). The prognosis of SCC variants, except for adenosquamous SCC, is comparable to that of conventional SCC. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to provide a structured protocol for the treatment of verrucous carcinoma (VC) based on size, bone invasion, recurrence and whether neck dissection is necessary or not. In addition, the study evaluates the probability of a wrong histopathological diagnosis. Data Sources: A search was conducted in the Cochrane Library, PubMed and Google from January 1962 to October 2022 by using MeSH terms and keywords. Studies reporting treatment modalities for VC and different histopathological diagnoses after excision of the lesion were selected except case reports and review articles. Study Eligibility Criteria: Thirteen articles were selected. Six hundred and thirty cases of VC were treated by surgery, surgery + neck dissection, radiotherapy, chemotherapy and combination therapy. Statistical analysis revealed surgical treatment as a preferred option. Despite being enlarged, the lymph node was negative for metastasis. So, in OVC cases neck dissection adds only unnecessary morbidity to patients. Participants and Interventions: Radiotherapy or chemotherapy can be used to downstage the disease. 23.3% of cases reported wrong histopathology diagnosis. Study Appraisal and Synthesis Methods: Patients treated for squamous cell carcinoma (SCC) will only experience unnecessary morbidity unless the correct diagnosis is made between VC and hybrid VC. Irrespective of size VC does not metastasise until there are no foci of SCC. Conclusions: Surgical excision of T1- and T2-sized lesions can be performed under local anaesthetic as a biopsy procedure. T3 or T4 lesion can be resected with a safe margin. If it comes as hybrid VC or VC with close margin (0.5 cm, <0.5 cm), neck dissection and further margin should be excised as a second procedure respectively. [ABSTRACT FROM AUTHOR]

To assess the utility of Narrow Band Imaging (NBI) as a diagnostic tool in evaluating laryngeal pathology in patients presenting with hoarseness. Study design: Prospective cross sectional diagnostic study. Methods: 200 patients with voice change were recruited and laryngeal findings documented with high definition flexible endoscopy with both white light and narrow band light and the representative still images recorded for analysis. The NBI intraepithelial papillary capillary loop (IPCL) patterns was compared with the histopathology report. Of the 200 patients evaluated, 84 lesions were biopsied which included both benign and malignant lesions. The sensitivity obtained was 73.3% [54.1–87.7% with 95% CI] and the specificity was 87% [75.1–94.6% with 95% CI] for detecting malignant lesions. NBI can be considered as a useful diagnostic tool in evaluating laryngeal pathology and can be used to detect early premalignant and malignant lesions. [ABSTRACT FROM AUTHOR]

Cutaneous horns are uncommon lesions which consist of proliferation of keratotic material resembling that of an animal horn. This lesion most commonly occurs in sun-exposed areas, particularly the face, ear, nose, forearms and dorsum of hands. The purpose of the study was to highlight the atypical presentation of squamous cell carcinoma as a giant cutaneous horn along with the review of literature. Case details were obtained from hospital records and clinical and histopathological findings were noted. Herein we report two cases of giant cutaneous horn associated with an underlying carcinoma presenting at an uncommon site. Both the patients were adults and had a chronic history of a skin lesion over the affected sites. Wide local excision was performed in both cases and histopathological examination confirmed the diagnosis of a cutaneous horn with a well differentiated squamous cell carcinoma at the base of the horn. Cutaneous horns are commonly associated with benign lesions and rarely with malignant conditions. It is imperative to biopsy the base of the horn to rule out any underlying malignancy. Proper surgical excision with adequate margins is the preferred treatment in case of an underlying malignancy. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to provide an overview of the literature on carcinoma arising from giant perianal condyloma acuminatum. Methods: We present a new case of squamous cell carcinoma arising from giant perianal condyloma acuminatum. We also conducted a systematic search of the medical literature using PubMed, Medline, Google, and Google Scholar related to carcinoma arising from giant perianal condyloma acuminatum. The following search terms were used in various combinations: condyloma acuminatum, giant condyloma acuminatum, Buschke-Lowenstein tumor, squamous cell carcinoma, and verrucous carcinoma. The search included articles published before in the English language November 2020. Results: A total of 55 article concerning 97 patients with carcinoma (squamous cell carcinoma, verrucous carcinoma, basaloid cell carcinoma, carcinoma insitu) arising from giant perianal condyloma acuminatum meeting the aforementioned criteria were included. The patients were aged from 24 to 82 years (median: 49.6, IQR: 21); 20 were female (median age: 52.5, IQR: 20.5), and 75 were male (median age: 53, IQR: 17.5). The gender data of the remaining two patients could not be obtained. The histopathological features of tumors arising from giant condyloma acuminatum are as follows: squamous cell carcinoma (n = 56), squamous cell carcinoma in situ (n = 16), verrucous carcinoma (n = 19) and basaloid cell carcinoma (n = 1), squamous cell carcinoma + verrucous carcinoma (n = 1), squamous cell carcinoma + squamous cell carcinoma in situ (n = 1), squamous cell carcinoma + basaloid cell carcinoma (n = 1) and malignant behavior (n = 2). Conclusion: Giant condyloma acuminatum is a rare variant of anogenital warts. It is known that this tumor, which is mostly thought to be benign, has a high potential for local recurrence and transformation into invasive cancer. Therefore, it is vital that the tumor is resected with clean surgical margins, even if it looks benign, and that aggressive treatment options are not avoided when necessary. [ABSTRACT FROM AUTHOR]

Abstract Background Oral carcinoma cuniculatum (OCC) is an unacquainted well-differentiated subtype of oral squamous cell carcinoma, which displays unique clinic-pathological features. Up to date, OCC remains rare with about 75 reported cases, and is frequently missed or even misdiagnosed. Case presentation The aim of the present work was: to report a case of OCC in mandibular gingiva and to highlight its main clinic-pathological diagnostic features: with an exophytic cobble-stone surface and a characteristic endophytic burrowing architecture, as well as to differentiate between it and other closely similar lesions including verrucous carcinoma, papillary squamous cell carcinoma, and well-differentiated conventional oral squamous cell carcinoma. Conclusions An accurate diagnosis of OCC entails awareness of the clinicians and pathologists about its entity, proper knowledge of the diagnostic clinical and histopathological evidence, and the ability to differentiate it from closely similar lesions.

Background: Cutaneous verrucous carcinoma (CVC) is a rare variant of squamous cell carcinoma and sometimes shares similar clinical and histopathological features with other verrucous lesions. Methods: We performed a retrospective study of 21 patients diagnosed with CVC between 2012 and 2022 by reviewing clinical and histopathological data. We also compared the clinicopathological features of patients with CVC, giant condyloma acuminatum (GCA), and pseudoepitheliomatous hyperplasia (PEH). We obtained follow-up data by reviewing medical records and telephone interviews. Results: The average age of patients with CVC was 63.6 years, with a male predominance. The location of disease is mostly found in the foot, followed by the lower legs. Histologically, CVC is characterized by an exo-endophytic growth pattern with severe keratinization and a blunted rete ridge with pushing margins. Clinical features including exudation and crusting, induration, irregular borders, and warty surface, as well as pathological features including growth pattern, koilocytotic cells, depth and morphologic features of acanthosis, severe keratinization, and degree of dermal inflammation, were significant in distinguishing cutaneous CVC, GCA, and PEH. Conclusion: Identification of the clinicopathological features is essential to distinguish CVC from its mimics and to make an early diagnosis. Because of the potential for recurrence and metastasis, CVC requires aggressive treatment. [ABSTRACT FROM AUTHOR]

Verrucous Carcinoma is a rarely occurring, well-differentiated, low-grade squamous cell carcinoma. We describe a case of verrucous carcinoma of the mandible in a 55-year-old male patient who had an exophytic growth in the anterior part of the mandible. The growth in the edentulous anterior mandible was painless, but the patient was disturbed by the increase in size and alteration of form. Incisional biopsy and histopathology revealed verrucous Carcinoma. The treatment chosen was the middle third mandibulectomy and reconstruction. Very often the clinician rethinks the treatment modality chosen especially when going in for extensive surgery. [ABSTRACT FROM AUTHOR]

Verrucous carcinoma (VC) is a locally invasive uncommon histopathological variant of oral squamous cell cancer. There is paucity of literature regarding control rates in these cases. We intend to report the outcomes in terms of administered treatment and control rates. 28 patients of oral cavity verrucous carcinomas treated at our institute from March 2014 to December 2018 were reviewed retrospectively. Demographic profile, histopathological features and clinical outcomes were analyzed. Statistical analysis was performed with SPSS for Mac (version 23.0). Median age was 54 years (range 31–75) with M:F ratio of 25:3. Buccal mucosa was the most common site. All patients underwent surgical resection except one. Of these, 24 had neck dissection; 12 had supra-omohyoid neck dissection, eleven had modified neck dissection and one patient underwent radical neck dissection. Three patients had their histology upgraded to squamous cell carcinomas in the post-operative histopathology. The post-operative staging was as follows: 21% stage I and 35% stage II. One patient opted for non-surgical approach and received radical concurrent chemoradiotherapy. Median follow up was 12 months (range 6–36). Two patients had local failures and one had a regional failure. No distant metastasis was found. There was one death. 14-Months survival rate was 92%. Estimated 18 month loco-regional control rate was 92%. Curative surgical resection remains the cornerstone for VC of oral cavity. Any change of histopathology post-operatively to squamous cell carcinoma is a poor prognostic sign and needs appropriate adjuvant treatment. [ABSTRACT FROM AUTHOR]

Verrucous carcinoma of oral cavity is a highly well differentiated variant of squamous cell carcinoma with a low potential for invasion and metastasis. It is prevalent in the tobacco quid chewing population in our region. In this observational study, we reviewed the medical case records of 58 patients treated for oral verrucous carcinoma staged T2 to T4a. All patients underwent wide excision of tumour which included marginal mandibulectomy in 22 and hemimandibulectomy in 23 patients along with neck dissection saving the accessory nerve and internal jugular vein. 5 patients were found to have bone involvement along the alveolar sockets. 11 patients had other associated premalignant lesions in oral cavity. Only 2 patients had lymph node metastasis without extra nodal spread in submandibular region. With a mean follow up of 6 years and minimum follow up of 1 year, 3 patients had local recurrence. All these 3 patients had bone involvement and 2 of them had lymph node metastasis on histopathological examination. 3 patients who had associated premalignant lesions developed second primary in oral cavity after 3 years. In our experience, verrucous carcinoma has good prognosis when treated by surgery. Bone involvement along alveolar sockets and associated oral premalignant lesions adversely affect the outcome. There was no difference in the outcome between selective and modified radical neck dissection. Therefore selective neck dissection (supraomohyoid) would be adequate in treating these patients. Adjuvant radiotherapy can be reserved for T4a lesions or for positive margins. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). Study Design: Retrospective cohort study. Methods: A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. Results: A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70–0.95]) and stage III–IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74–3.05], P =.23). Propensity score analysis also showed no OS benefit with the use of PORT (P =.41). Conclusions: Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III–IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. Level of Evidence: 4 Laryngoscope, 132:1953–1961, 2022 [ABSTRACT FROM AUTHOR]

A retrospective clinicopathological analysis was performed to compare 35 proliferative verrucous leukoplakia (PVL), 40 leukoplakia without dysplasia (LK), 48 oral lichen planus (OLP)/oral lichenoid lesions (OLL), and 11 verrucous carcinoma (VC) (N = 134). The PVL group comprised 24 female and 11 male patients (mean age 66.5 years), with two to six sites involved (mean 3.1 sites) and multiple biopsies over time (mean 7.1/case). All PVL cases developed malignancy: 77.1% squamous cell and 40% verrucous carcinoma; 68.6% had multiple sites of malignancy. None showed local or distant metastatic spread. Five-year disease-specific survival was 88.6%. In LK and OLP/OLL, malignant transformation was significantly lower than in PVL (2.5% and 2.1%, respectively). Invasive squamous cell carcinoma was not reported in any conventional VC. Immunohistochemical histomorphometric analysis for p53, COX-2, and podoplanin showed no significant differences between the groups. PVL may overlap with LK, OLP/OLL, and VC, but has a persistent aggressive behaviour and high malignant transformation rate. The overlapping features may delay recognition as PVL. The results emphasize the need for a detailed clinicopathological definition of PVL, and long-term close monitoring to ensure progression to PVL and malignancy are recognized in time. The management of this persistent aggressive condition is challenging. [ABSTRACT FROM AUTHOR]

Background: There are many different variants of squamous cell carcinoma (SCC), and verrucous carcinoma (VC) is a rare and highly differentiated SCC. Due to its preference of local invasion, regional lymphatic involvement rarely occurs. VC is difficult to diagnose using conventional pap smear or cervical punch biopsy, in which adequate stroma including bulbous rete pegs is required for a definitive diagnosis. Surgical management is recommended as the first-line treatment with radiotherapy forbidden due to the risk of anaplastic transformation. Case report: We presented a 59-year-old Taiwanese female who had postmenopausal bleeding for three months with two consecutive normal pap smear and biopsy at other hospital. Pelvic examination showed a necrotic fungating cervical mass with upper 1/3 vaginal involvement. Colposcopic guided cervical biopsy and fractional dilatation and curettage revealed verrucous hyperplasia (VH) with negative high-risk HPV typing. Pelvic 3T magnetic resonance imaging (MRI) was arranged, and a 3.7 × 3.6 × 4.0 cm necrotic mass at the cervix with an enlarged left pelvic lymph node was found. Positron emission tomography with computed tomography (PET/CT) demonstrated avid uptake at the cervix and left pelvic lymph node. Surgical intervention was performed due to highly suspicious of cervical verrucous carcinoma with positive pelvic lymph node. The final pathologic report was a well-differentiated verrucous carcinoma, IIA2 by International Federation of Gynecology and Obstetrics (FIGO) classification. Conclusion: VC is difficult to diagnose preoperatively, and surgical excision is recommended as the first-line treatment.

Cutaneous horn is a protuberance constituted by compact keratinous material, with a hard consistence similar to a horn, which occurs more frequently in photoexposed areas. The authors describe a case of cutaneous horn on the glans considered a rare location. Verrucous carcinoma was the histopathological diagnosis of the base of the horn and lichen sclerosis, the precursor lesion.

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma (SCC) characterized by its histological presentation as a low-grade tumor with no potential for metastasis, setting it apart from invasive SCC. However, distinguishing VC from its benign counterpart, verrucous hyperplasia (VH), is challenging due to their clinical and morphological similarities. Despite the importance of accurate diagnosis for determining treatment strategies, diagnosis of VH and VC relied only on lesion recurrence after resection. To address this challenge, we generated RNA profiling data from tissue samples of VH and VC patients to identify novel diagnostic markers. We analyzed differentially expressed (DE) mRNA and long non-coding RNA (lncRNA) in tissue samples from VH and VC patients. Additionally, ChIP-X Enrichment Analysis 3 (ChEA3) was conducted to identify the top five transcription factors potentially regulating the expression of DE mRNAs in VH and VC. Our analysis of mRNA and lncRNA expression profiles in VH and VC provides insights into the underlying molecular characteristics of these diseases and offers potential new diagnostic markers. The identification of specific DE genes and lncRNAs may enable clinicians to more accurately differentiate between VH and VC, leading to better treatment choices. • Commonly upregulated mRNA in both VH and VC was enriched in keratinocyte differentiation and keratinization related processes • Upregulated mRNAs in VH were enriched in skin development and keratinocyte differentiation • Upregulated mRNAs in VC were enriched in response to stress and connective tissue development • Identified lncRNAs potentially influence the noninvasive phenotype in VH and less malignant behavior in VC • Our study provides new insights into the molecular mechanisms underlying VH and VC [ABSTRACT FROM AUTHOR]

• OVC, presenting uniquely with PVL, has limited treatment options. • PDT effectively preserves both the function and appearance of the oral cavity. • PDT may become a preferred treatment option for PVL and early-stage OVC. Oral verrucous carcinoma (OVC) and proliferative verrucous leukoplakia (PVL) share similar histological characteristics and may have a common origin. When they appear simultaneously, the risk of malignant transformation in PVL increases. In elderly patients with both conditions, a safe, effective, simple, and minimally invasive treatment is preferable. Photodynamic therapy (PDT), a non-invasive treatment, utilizes specific wavelengths of light to activate photosensitizers, generating reactive oxygen species that selectively target malignant tissues with cytotoxic effects. This case report describes an elderly patient with coexisting extensive leukoplakia, PVL, and OVC, who achieved complete remission with no recurrence at 10 months following PDT. The treatment resulted in a satisfactory clinical outcome, preserving both the appearance and function of the oral cavity. [ABSTRACT FROM AUTHOR]

Background: Verrucous carcinoma of the esophagus (VCE) is a rare tumor that is difficult to diagnose. In most cases, biopsies show nonspecific inflammatory and hyperkeratotic changes and do not show malignant findings. Most VCEs are slowly growing, locally advanced tumors with few metastases. Treatments for VCE are the same as for normal esophageal cancer, involving combined chemotherapy, surgical resection, and radiation therapy. However, it has been reported that VCE has a poor response to radiation or chemoradiotherapy (CRT). A case of VCE with complete response (CR) after CRT is presented. Case presentation: A 70-year-old man was found to have white, irregular esophageal mucosa 4 years earlier. He had been followed up as an outpatient as having candidal esophagitis. However, his tumor grew gradually, and biopsy was performed by endoscopic mucosal resection (EMR). He was finally diagnosed with VCE. He had no metastases to distant organs, but some lymph node metastases were suspected. The tumor invaded his left bronchus. The esophagostomy and gastrostomy were constructed as emergent procedures. The patient then underwent definitive CRT. 4 weeks after the end of CRT, two-stage esophagectomy was performed. First, he underwent esophagectomy with thoracic lymph node dissection. A latissimus dorsi flap was patched to the bronchus after primary suture of the hole. 6 weeks later, reconstruction of the gastric tube was performed through the antethoracic route. The pathological findings showed CR to CRT, with no proliferative cancer cells in the specimen. The patient has had no recurrence for three and half years after the resection. Conclusions: We presented a locally advanced VCE that achieved CR to CRT. In cases that have some difficulty for local resection, CRT might be an appropriate treatment for VCE. [ABSTRACT FROM AUTHOR]

Introduction Traditionally, larger lesions of laryngeal verrucous carcinoma are treated with surgical excision, with definitive radiotherapy generally reserved for smaller lesions. However, data utilizing modern databases is limited. Objective The authors sought to assess, utilizing the National Cancer Database, whether overall survival for patients with laryngeal verrucous carcinoma was equivalent when treated with definitive radiotherapy versus definitive surgery. Methods A retrospective cohort study was conducted utilizing the National Cancer Database. All cases of laryngeal verrucous carcinoma within the National Cancer Database between 2006 and 2014 were reviewed. Patients with T1-T3 (American Joint Commission on Cancer 7th Edition) laryngeal verrucous carcinoma were included and stratified by treatmentmodality. Demographics, treatment, and survival data were analyzed. Results A total of 392 patients were included. Two hundred and fifty patients underwent surgery and 142 received radiotherapy. The two groups differed in age, transition of care, clinical T stage, and clinical stages. There was no significant difference in survival between T1-T3 lesions treated with surgery or radiotherapy (p=0.32). Age, comorbidities, insurance status, and clinical T stage impacted overall hazard on multivariate analysis (p<0.01). For patients treated with radiotherapy, age, insurance status, and clinical T stage were predictive of increased hazard. Conclusion Overall survival is equivalent for patients with clinical T1 and clinical T2 laryngeal verrucous carcinoma treated with primary radiotherapy versus primary surgery. Thus, radiotherapy should be considered as a non-inferior treatment modality for certain patients with laryngeal verrucous carcinoma. [ABSTRACT FROM AUTHOR]

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Background: Cutaneous horn arising from the nasal vestibule is an extremely rare entity with only four published case reports to date. Although cutaneous horns are commonly benign, the risk of it harboring a malignant or pre-malignant process is about one in three. Verrucous carcinoma is a variant of squamous cell carcinoma (SCC) that typically presents in the oral cavity, and very rarely in the nasal cavity. Case Presentation: We report a 78-year-old female who presented with a rapidly enlarging right naris cutaneous horn of 5 months duration. Computed tomography scan showed a heterogeneously enhancing mass at the right anterior nasal cavity with no overt bone or cartilage destruction. Differential diagnoses included seborrheic keratosis, actinic keratosis, viral wart, and malignant tumors such as SCC. She underwent an excision biopsy and histology confirmed the diagnosis of a pT1 verrucous SCC. Conclusion: Due to the rarity of the site of the disease, management of sinonasal verrucous carcinoma is generally derived from management options of other subsites in the head and neck region. The preferred treatment modality is surgical excision, while primary radiotherapy is an emerging treatment alternative in poor surgical candidates [ABSTRACT FROM AUTHOR]

Verrucous carcinoma is a rare mucocutaneous malignancy characterized by slow, relentless growth and a low metastasis rate. Herein we summarize surgical success rates and review newer approaches to the treatment of verrucous carcinomas. PubMed electronic searches were performed by B.F. and C.V. using combinations of the following terms: "verrucous carcinoma," "Ackerman tumor," "Buschke Lowenstein," "epithelioma cuniculatum," "carcinoma cuniculatum," "papillomatosis cutis," "treatment," "therapeutics," "management," "mohs surgery," and "excision." A systematic review was conducted on 49 articles in accordance with PRISMA guidelines. Surgical management remains first-line therapy. Wide local excision is most commonly utilized, with highly variable margins (0.5–3.0 cm) and recurrence rates (4.6–75.0%). Mohs Micrographic Surgery has also been used, especially for recurrent tumors, with an overall recurrence rate of 12.9%. Surgery is the treatment of choice, either by Mohs Micrographic Surgery or wide local excision. However, surgical recurrence rates are high, and tissue-sparing therapies are desirable given the sensitive locations involved. Ultimately, randomized control trials are needed to develop evidence-based guidelines for the management of VCs. [ABSTRACT FROM AUTHOR]

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma. VC is histologically a benign tumor, but it grows significantly and eventually forms a huge mass. Many different treatments are known, but the first-line treatment is surgical resection. VC has strong local infiltration and frequently recurs, making its local control very difficult in unresectable cases. We present a rare case of VC that could be treated with combined radiotherapy and Mohs' chemosurgery, as a new option for unresectable VC. [ABSTRACT FROM AUTHOR]