A Troubling Diagnosis of Verrucous Squamous Cell Carcinoma (“the Bad Kind” of Keratosis) and the Need of Clinical and Pathological Correlations: A Review of the Literature with a Case Report

A Santoro,L Lo Muzio,S Papagerakis,P Bufo,G Pannone,M Contaldo,F Sanguedolce,V Esposito,R Serpico

doi:10.1155/2011/370605

Abstract

Verrucous carcinoma (also known as Ackerman tumor) is an uncommon exophytic low-grade well-differentiated variant of squamous cell carcinoma. This neoplasm typically involves the oral cavity, larynx, genitalia, skin, and esophagus. It is well known for its locally aggressiveness and for its clinically slow-growing behaviour with minimal metastatic potential. Verrucous carcinoma of oral cavity is so closely aligned with the use of snuff and chewing tobacco that it has been called the “snuff dipper's cancer”. Recent studies have proved the role of HPV. The typical clinical presentation of oral verrucous carcinoma has long been known, as its remarkably innocuous appearance and biological behaviour. In this work, we report a review of the scientific literature and describe a troublesome case of oral verrucous cancer.

Highlights

Verrucous carcinoma (VC) was defined by Ackerman in 1948 [1] as a diagnostically problematic squamous cell neoplasia involving lip, oropharyngeal, and laryngeal mucosa
Verrucous carcinoma of oral cavity is so closely aligned with the use of snuff and chewing tobacco that it has been called the “snuff dipper’s cancer”
Human papillomavirus could have a potential role in the tumoral development and progression, this topic is still under discussion [3]

Summary

Introduction

Verrucous carcinoma (VC) was defined by Ackerman in 1948 [1] as a diagnostically problematic squamous cell neoplasia involving lip, oropharyngeal, and laryngeal mucosa As a result, this neoplasm was named as “Ackerman’s tumor.”. In the head and neck district, VC most frequently involves the oral cavity, where it commonly arises from buccal mucosa and lip It is considered a slowly growing neoplasm that can reach considerable size before being brought to medical attention [4]. It appears as a papillary nonulcerated graywhite or red mass with a very broad base of attachment. We report a case of oral VC, referring all the diagnostic difficulties occurring in the clinicopathological examination

Case Report

Gross and Microscopic Findings

Review of the Literature and Conclusion