Verrucous Carcinoma Research Articles

Buschke-Lowenstein Tumors: A Review and Proposed Classification System.

Buschke-Lowenstein (B-L) tumors or giant condylomata are large fungating lesions that are caused by human papillomavirus (HPV) and develop in the anogenital region. Although uncommon, physicians and surgeons who treat sexually transmitted diseases or other diseases involving the anogenital area will encounter these patients. The purpose of this study is to review the current literature regarding these lesions. We evaluated every published study in PubMed and Embase from 1925 to 2020, concentrating on the clinical data included in each report, such as presentation and treatment. We also evaluated each work for any definition used and found that there is no accepted definition for these lesions. As such, we provide an inclusive, workable definition. In addition, there are many misconceptions about B-L that continue to be propogated as more case reports are published every year. After evaluating every published case, we refute the fact that these lesions have a high mortality or a high malignancy rate. Furthermore, we refute that these lesions are synonymous with verrucous carcinoma. In addition to a definition, we also propose a simple grading system that we hope can be used to assist in the study and management of these patients moving forward. Although the literature is very heterogenous regarding B-L, they are caused by HPV and are distinct from verrucous carcinoma. Because of the majority of information is based on case reports, the literature concentrates on treatment, but more work is clearly needed to delineate the association with specific HPV types and optimal management of this disease.

Histopathological interpretation of oral cavity lesions

Although the oral cavity lesions constitute only a small minority of pathological conditions, they are of great significance, as they have a potential to jeopardize the health and longevity of the patient. Among the various oral cavity lesions, oral cancer is a global health problem with increasing incidence and mortality rates. In India a vast majority of oral cancers are preceded by precancerous lesions & conditions caused by the use of tobacco in various forms. The aim of the present study is to know the spectrum and patterns of various oral cavity lesion. All the oral cavity specimens received in the Department of Oral Pathology, during the study period were included for the study. Data such as age, gender, and site of the lesion was collected. Data collected was analyzed. A total of 100 cases were analyzed during the study period. Age ranged from 2 to 78 years in the study. Overall male were affected more than the female with male: female (M:F) ratio of 3.5:1. Buccal mucosa (33%) was the commonest site involved followed by tongue (28%). Neoplastic lesions accounted for 69% cases and non-neoplastic accounted for 31% cases. Among the neoplastic lesion, squamous cell carcinoma (SCC) was seen in 40% cases; verrucous carcinoma in 6% and ameloblastic carcinoma in 1% cases; and adenosquamous carcinoma 1% cases. Most of the malignant lesions were located in the buccal mucosa (16%) and tongue (15%), followed by gingiva (6%), palate & floor of mouth (4%) each, lips (2%) alveolus (1%). Histology along with a detailed clinical work-up was found to be a useful, reliable and accurate diagnostic technique for lesions of oral cavity. A variety of lesions were encountered in the study with predominance of malignant lesions. Squamous cell carcinoma was the commonest malignant lesion.

Excisional Biopsy of Verrucous Carcinoma of Tongue using Diode Laser

Oral verrucous carcinoma (OVC) is a subtle variant of oral squamous cell carcinoma with some peculiar features. It is locally invasive growth which rarely metastasizes. Verrucous carcinoma rarely affects the tongue. Herein, we report a case of excisional biopsy of a grayish-white lesion on the left lateral surface of the tongue performed with a 940-nm diode laser, which upon histopathological examination was diagnosed as OVC.

Varied Presentation of Oral Verrucous Carcinoma in a Tertiary Hospital of Dhaka City

Introduction: Ackerman’s tumor or Verrucous carcinoma is a distinguished clinic-pathological variant of squamous cell carcinoma, presenting with multiple clinical presentations. This study provides a contemporary survey of morphological presentation of oral verrucous carcinoma (OVC) in the oral cavity with site of predilection and possible etiological factors.
 Method: An observational studywas conducted from January 2014 to June 2016.A suspected patient diagnosed clinically and histologically as OVC at the Dhaka Dental College Hospital (DDCH) was enrolled in this study. Results: In this study total 15 number of patients male were 53.3% and female were 47%. The morphological presentation of the study was proliferative and verrucous, each of which comprises 40.0% of cases. The tumor's primary site was the buccal mucosa 46.67% and history ofbetel quid chewing was 46.9%.
 Conclusion: The study concluded that it is very difficult to distinguishing clinically between verrucous carcinoma and other exophytic lesions of the oral cavity. OVC presents with different morphological presentation such as proliferative and verrucous types. Buccal mucosa is the site of predilection.
 J Bangladesh Coll Phys Surg 2021; 39(2): 80-86

Verrucous carcinoma in association with oral submucous fibrosis

ABSTRACT -Oral verrucous carcinoma is a form of well differentiated squamous cell carcinoma characterized by exophytic over growth. It is slow growing and locally invasive tumor occurring in 6 th and 7 th decade of life. Smoking and chewing tobacco is found to be the most common etiological factor of verrucous carcinoma although oral leukoplakia may act as a predisposing factor. This is a rare case of oral verrucous Carcinoma seen in association with oral submucous fibrosis in a young adult patient with history of chewing gutkha and smoking.

Oral Cancer: Raising Awareness of the Importance of Suspicion in Early Detection.

Oral cancer is a significant cause of morbidity and mortality worldwide. In this article we present two cases of potentially innocuous looking lesions, initially thought to be traumatic in origin, but later diagnosed as cancer. The first patient presented with a persistent laceration thought to be caused by an accidental shaving injury, which was subsequently diagnosed as squamous cell carcinoma. The second patient presented with a hyperplastic mucosal lesion, suspected as forming due to denture-clasp irritation, which was subsequently diagnosed as proliferative verrucous carcinoma. The importance of early detection and palpation of suspicious lesions is emphasised in this article.

Prognostic Implications of ALDH1 and Notch1 in Different Subtypes of Oral Cancer.

Background The present study aimed to investigate the clinical significance and prognostic value of the immunoexpression of cancer stem cell markers, ALDH1 and Notch1, in subtypes of oral squamous cell carcinoma. Materials and Methods The expression of ALDH1 and Notch1 in 63 patients with well and poorly differentiated oral squamous cell carcinomas and their subtypes, verrucous carcinoma and basaloid squamous cell carcinoma, was evaluated by immunohistochemistry. The semi-quantitative analysis of the ALDH1 and Notch immunoexpression levels, based on the capture of 10 microscopic fields, at 400X magnification, at the invasive tumor front was performed and associated with clinicopathological variables using the chi-square test or Fisher's exact test. The overall and disease-free survival rates were estimated according to the Kaplan–Meier method and the curves were compared using the log-rank test. The independent effects of variables were calculated using Cox's proportional hazards regression model. Results Strong ALDH1 and Notch1 expression was observed in 16 (25.4%) and 27 (42.9%) oral squamous cell carcinomas including their subtypes, respectively. Most tumors with strong immunoexpression of ALDH1 were basaloid squamous cell carcinoma (56.3%). Statistically significant associations were observed between the strong immunoexpression of Notch1 in poorly differentiated oral squamous cell carcinoma with perineural infiltration (p = 0.011) and lymph node involvement (pN+) (p = 0.034). The strong immunoexpression of ALDH1 was a prognostic factor associated with worse overall survival (p = 0.040) for patients with oral cancer. Conclusion The strong immunoexpression of Notch1 can contribute to identification of patients with poorly differentiated oral squamous cell carcinoma, who have perineural infiltration or lymph node metastasis. In addition, the strong immunoexpression of ALDH1 may help to identify a worse prognosis in patients with oral squamous cell carcinoma and their subtypes.

Optimal treatment for penile verrucous carcinoma: a systematic literature review

BackgroundVerrucous carcinoma, a rare low-grade well-differentiated squamous cell carcinoma, is known for its favorable biological behavior and lack of metastatic potential. However, aggressive resection is problematic in terms of compromised function and aesthetics. Hence, more conservative treatments are needed. Methods: To identify the up-to-date general biological behavior, diagnosis, and treatment trends, we searched PubMed using the keyword “penile verrucous carcinoma” without restrictions on publication date. Results: Current treatments for penile verrucous carcinoma include wide surgical excision, seldom preventive lymphadenectomy, and conservative chemotherapy without surgery or local excision with safe margins. Despite the advent of partial penectomy to minimally impact function and aesthetics, affected patients experience psychosexual problems. Local excision can be used to save the penile shaft and glans penis without preventive lymphadenectomy or adjuvant therapy and can achieve good clinical prognosis with rare recurrence. Conclusions: To preserve the functional and cosmetic aspects, we recommend local excision, especially for tumors measuring < 3 cm and classified as stage T1 according to the 2016 tumor node metastasis clinical and pathological classification for penile cancer.

Oral hybrid verrucous carcinoma: A challenging entity to clinicians

Background: Oral Verrucous Carcinoma (OVC) is defined as a verrucous variant of Squamous Cell Carcinoma (SCC) characterized by a predominantly exophytic growth of well-differentiated keratinized epithelium, with deep margins of locally aggressive invasion. The incidence of OVC is approximately 3% of all oral cancers. Its pathogenesis include chemical carcinogenesis induced by tobacco smoke, alcohol consumption, betel nut chewing and chronic inflammation. OVC occurs predominantly in people of advanced age and in males. The most common sites of involvement of the oral mucosa include the cheek mucosa, followed by the gum and tongue.

TO SEE THE HISTO-PATHOLOGICAL PATTERN OF ORAL MUCOSAL LESIONS

Background &amp; Method: This prospective observational study was carried out with total number of patients 60 in the Department of Otorhinolaryngology and head and neck surgery, Amaltas Institute of Medical Sciences, Dewas, M.P., w.e.f. from August 2018 to September 2020. Patient was thoroughly investigated for complete haemogram, blood sugar, blood urea, serum creatinine, bleeding &amp; Clotting time, coagulation profile, chest x-ray for any secondary focus.&#x0D; Result: Out of 35 cases of clinically premalignant lesions 30 cases were positive for malignant cells on histology. 5 were suspicious for malignant cells. Out of the 25 cases of clinically malignant lesions 25 cases were positive for malignant cells on histology and nil cases of suspicious for malignancy. In this present study, on histopathology premalignant lesions was found in 8.33% and malignancy was seen 91.66% cases. On histopathological examination, squamous cell carcinoma was the most common type among all cases (78.33%). In squamous cell carcinoma, keratinizing type was found in 33.33% and non- keratinizing type was found in 45%. Verrucous carcinoma was seen in 6.66% cases and verrucous hyperplasia was seen in 3.33% cases.&#x0D; Conclusion: We Concluded in the study as diagnosed by histopathology were found premalignant in 8.33% and malignant 91.66% cases. The type of cancer was determined by histo-pathological examination after biopsy. Squamous cell carcinoma was the most common type among all cases (78.33%). In squamous cell carcinoma, keratinizing type were found in 33.33% and non-keratinizing type were found in 45%, followed by verrucous carcinoma was seen in 6.66% cases, and verrucous hyperplasia was seen in 3.33% cases.&#x0D; Keywords: Histo-pathological, Oral Mucosal Lesions.

A Case of Erythroplasia of Queyrat Complicated with Verrucous Carcinoma

Erythroplasia of Queyrat is a rare squamous cell carcinoma that occurs in middle-aged, uncircumcised men, and usually involves the glans. The cause of this disease is still unclear, although it may be related to a redundant prepuce, phimosis, and human papillomavirus infection, and may develop into squamous cell carcinoma. A case of Erythroplasia of Queyrat, complicated by verrucous carcinoma, is reported in this paper.

Evaluation of squamous cell carcinoma antigen 1 expression in oral squamous cell carcinoma (tumor cells and peritumoral T-lymphocytes) and verrucous carcinoma and comparison with normal oral mucosa

Background:Squamous cell carcinoma antigen (SCCA) is used as a prognostic marker for recurrence of squamous cell carcinoma in various sites, including head and neck. Studies suggest that its high serum levels are correlated to some clinical features, such as nodal metastasis. However, it is still unknown if high SCCA in patients with SCCA tissue expression in tumor cells are related to peripheral T-lymphocytes. Therefore, we did this study to evaluate SCCA expression in squamous cell carcinoma and verrucous carcinoma and to compare it with normal oral mucosa, also investigating the correlation between serum-based and tissue-based antigen levels.Methodology:In this study, the immunohistochemistry (IHC) technique was used to determine the SCCA1 expression pattern in 81 specimens divided into 3 groups, including oral squamous cell carcinoma, verrucous carcinoma, and normal oral mucosa. Serum-based and tissue-based antigen levels of 20 oral squamous cell carcinoma cases were compared by the western blot assay. SCCA expression was also evaluated and compared in both tumor cells and peripheral T-lymphocytes by the immunofluorescence assay.Results:Our results showed that the SCCA levels in SCC specimens were significantly lower than in verrucous carcinoma and normal and hyperplastic oral mucosa specimens. We found no correlation between the IHC expression of SCCA and serum levels. SCCA was well expressed in both tumor cells and peripheral T-lymphocytes.Conclusion:Decreasing SCCA in SCC specimens suggested that SCC tumor cells may affect more than the serum levels of SCCA in some patients. In addition, expression of SCCA in peripheral T-lymphocytes showed that both tumor cells and T-lymphocytes may cause serum SCCA.

Surgical treatment of verrucous carcinoma of the vulva - 15-year experience and literature review

This paper seeks to present surgical procedures, results and complications of treatment of verrucous carcinoma (VC) of the vulva treated at the clinics for gynecology and obstetrics within the Faculty of Medicine, University of Novi Sad (Serbia), as well as a literature review of surgical treatment of VC. During a period of 15 years (2005?2019), we performed 76 surgeries of vulvar cancer, nine (11.8%) due to VC of the vulva. In surgical treatment of vulva VC, we performed complete surgical excision of the tumor (three), complete surgical excision of the tumor with defect coverage using VY fasciocutaneous skin flap (two), simplex vulvectomy (two), radical hemivulvectomy (one), and radical vulvectomy (one). We came across two main complications (22.2%): suture bleeding within 12 hours after excision in one patient (11.1%) and lower extremity lymphoedema after inguinofemoral lymphadenectomy with ligation of the great saphenous vein in one patient (11.1%). Out of the total number of nine treated patients, survival rate was 88.8% (eight patients) with death rate of 11.1% (one patient) within 12 months after surgery. In three patients (33.3%), the disease returned after surgery: one residual tumor after surgery, one relapse on the other side one year after surgery, one newly developed invasive squamous cell carcinoma 10 years after primary surgery.

Prevalence of Human Papillomavirus (HPV) 16 and 18 in Oral Malignant and Potentially Malignant Disorders: A Polymerase Chain Reaction Analysis - A Comparative Study.

Introduction:Human papillomavirus (HPV) are now being increasingly associated as a cause of oral squamous cell carcinomas (OSCC). This study was designed to evaluate the prevalence of HPV in Pelizaeus-Merzbacher disease (PMD) and OSCC using polymerase chain reaction that might help in better understanding of the role played by this virus in the oncogenic process even from its evolution stage.Materials and Methods:Formalin-fixed paraffin-embedded tissue samples (n = 40) of OSCC and mild, moderate, and severe dysplasia were used for this study. DNA was quantified and checked for purity spectrophotometrically. Statistical analysis was performed using SPSS software and statistical significance was assessed using Fischer's exact test (p < 0.05 was considered significant).Results:High-risk (HR)-HPV-16 was found to be positive in 35% of OSCC cases which showed a statistically significant association of HPV 16 with OSCC. Verrucous carcinoma had predominant HPV 16 infection (60%), followed by SCC with 40%. However, this association was not statistically significant. None of the OSCC samples were infected with HPV 18. Among the PMD, we found only 5% showing HR-HPV 16 infection which was not significant.Discussion:Although OSCC is attributed to tobacco and alcohol consumption, a significant proportion of OSCC cases have been demonstrated to contain HPV types. The high-risk HPV type 16 tends to be the most predominant type detected in cases of OSCC.

Verrucous carcinoma

Verrucous carcinoma

Lasers and energy-based devices for treating Pre-cancerous and Non-Melanoma Skin Cancers: A review of literature

Skin cancer has been the most common type of malignancies overall with an increasing incidence. The standard of treatment is surgical excision or Mohs Microscopic surgery for high-risk cancer or sensitive areas. Lasers have been used with promising results for treating non-melanoma skin cancers. This paper provides an overall review of the available lasers and energy-based devices utilized for treating NMSK; Squamous Cell Carcinoma In Situ, Invasive Squamous Cell Carcinoma, Basal Cell Carcinoma, Keratoacanthoma, Verrucous carcinoma, and the pre-cancerous Actinic keratosis, and Porokeratosis

Clinical Anatomopathological and Therapeutic Aspects of Buschke-Lowenstein Tumor

Introduction: Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. Patients and Method: Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. Result: A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. Conclusion: BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.

Gaint Condylomata Acuminate of Buschke-Lowenstein in Woman with HPV Infection: Clinical Presentation and Treatment

Buschke-Lowenstein Tumor (BLT) is a very rare sexually- transmitted disease associated with human papillomavirus type 6 and 11, but rare cases of oncogenic HPV types including HPV 16 and HPV 18 were also reported. BLT is located in the genital, anorectal and perianal regions. It is regarded as a type of verrucous carcinoma occurring on anogenital mucosal surfaces where it is locally invasive but displays a benign cytology. Buschke-Lowenstein tumor can be associated with a high rate of recurrence and a risk of malignant transformation to invasive SCC, especially in patients with oncogenic types of HPV. We report the case of a 59-year-old female patient who addressed our clinic for a large, exophytic, cauliflower-like tumor involving the vulva, perineum and perianal regions with 20 years duration. The first lesions had been appeared on vulva and after 3 years period they grown slowly and covered perineum and perianal area. They had cauliflower like surface, with different sizes. In some points erosions and yellowish secretion with odor are observed. Histologic examination of a biopsy specimen of large tumor presented nets of well- differentiated squamous cell carcinoma, as well as a marked mononuclear cell infiltrate and conspicuous koilocytosis. HPV DNA for 6 and 11 types was detected with PCR. The patient was sent to the gynecology surgery department for excision and remains under the supervision of the dermatology and oncology department for rapid treatment of relapses and early detection of malignant transformation.

头皮疣状癌伴皮角一例并文献复习

头皮疣状癌伴皮角一例并文献复习

Pseudoepitheliomatous Keratotic and Micaceous Balanitis

Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB), an uncommon glans penis skin disorder, affects mainly elderly men and can progress to verrucous carcinoma or invasive squamous cell carcinoma. A 22-year-old male presented with a 5-year history of a slightly pruritic thick scaly plaque on the glans penis that appeared 2 months after undergoing circumcision. Physical examination revealed a well-defined hyperkeratotic plaque with thin mica-like scales. Histological examination of previous biopsies showed acanthosis with elongation of the rete ridges, prominent granular cell layer, and marked orthokeratotic hyperkeratosis. The diagnosis of plaque-stage PKMB was made. The patient had monthly sessions of topical liquid nitrogen and after 20 weeks, the plaque shrank significantly.