Verrucous carcinoma of the vulva: diagnosis and treatment

Abstract

Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Lesions present in the form of a verrucous, ulcerated, and bleeding tumor that can reach large dimensions. This type of tumor can be mistaken for condylomata, both macroscopically and microscopically. We report the case of an 81-year-old patient with a large vulvar tumor presented for eight years, initially considered as a Buschke-Löwenstein tumor. The patient underwent radical vulvectomy with a V-Y advancement flap technique. This type of tumor should be considered by clinicians dealing with condylomatous ulcerative lesions that do not respond to the usual treatment.

Pembrolizumab in FIGO IVB Verrucous Carcinoma of the Vulva: A Case Report

“…The exact pathogenesis of verrucous carcinoma of vulva remains unclear. Though human papillomavirus (HPV) infection has been considered as a risk factor for the pathogenesis of this tumor (10,11), the role for HPV is doubtful (9). Usually, this rare type of pathology occurs in elderly postmenopausal women, premenopausal women with this tumor often have HPV infection (8,12).…”

Oral retinoid, acitretin, is effective in the management of resistant recurrent vulval verrucous carcinoma: A case report

“…Vulval cancers are rare, comprising approximately 1% of malignancies in women. Verrucous carcinomas of the vulva are rarer, yet accounting for 1% of vulval cancers 8,9 …”

“…Verrucous carcinomas are a rare variant of squamous cell carcinoma first characterized by Ackerman in 1948 1 . While Ackerman had first described them in the oral cavity, verrucous carcinomas have been diagnosed in other cutaneous and mucosal sites; commonly as head and neck neoplasms in the palate, 2 esophagus 3,4 laryngeal mucosa 5 and rarely in the genitourinary tract such as vulva, 6–9 cervix, 10–12 endometrium 13 and bladder 14 . Verrucous carcinoma of the vulva is rare, and all cases have been described in case reports 6–9,15,16 …”

“…Verrucous carcinomas are exophytic growths with a wart‐like appearance, which are locally invasive and rarely metastasize to lymph nodes 2,9 . The WHO Classification of Tumours of Female Reproductive Organs 17 describes them as ‘warty‐appearing, highly differentiated, variably keratinised.’ The pathophysiology of these neoplasms is unclear.…”

“…Histologically, they do not exhibit significant nuclear atypia 2,17 . Verrucous carcinoma is a rare condition, accounting for less than 1% of vulval carcinomas 8,9,16 . Surgical excision is the management of choice 8 …”