Ackerman's tumor (verrucous carcinoma) of the larynx. A clinicopathologic study of 77 cases

Abstract

A series of 77 cases of verrucous carcinoma of the larynx is presented. The tumor is relatively rare and the present series has been selected from 2,398 primary and recurrent malignant neoplasms of the larynx and hypopharynx evaluated at the Department of Otolaryngology of Padua University during the period from January 1966 to December 1978. The median age of patients was 58 years. The tumor appears to be exophytic, broadly implanted and fungating in aspect, with papillary fronds and a locally invasive character. It is composed of highly differentiated epithelial squamous cells covered by a thick keratinized layer arranged in deeply invaginated folds. Cellular response in tumor stroma is marked, and the neoplasm has a low‐grade malignancy. Close cooperation between the pathologist and the clinician is needed in order to establish the nature of the lesion, which looks clinically malignant but may appear histologically benign. Benign responses such as hyperkeratosis, acanthosis, or the presence of a benign papillomatous area necessitate further investigation with another biopsy examination from deeper layers. The elective treatment is surgery, as irradiation may cause anaplastic transformation with metastatic spread. Neck dissection is not indicated as this laryngeal tumor has so far never metastasized to cervical lymph nodes or to other organs.

Verrucous Carcinoma with Dysplasia or Minimal Invasion: A Variant of Verrucous Carcinoma with Extremely Favorable Prognosis

“…Another study involving 30 cases of laryngeal VC also showed that surgery is the optimal therapy but that radiation and even chemotherapy can be used as alternatives for inoperable cases [20]. Although the older literature raised the issue of radiotherapy-related anaplastic or malignant transformation in VC [3,9,[21][22][23][24][25], this has clearly been refuted. Radiotherapy is now an accepted treatment modality for inoperable VC or for patients who are poor surgical candidates [26,27].…”

Temporal Bone Verrucous Carcinoma: Outcomes and Treatment Controversy

“…Traditionally, possible risks have been suggested to be associated with adjuvant radiation therapy for verrucous Ferlito et al [3] n/a n/a n/a Hagiwara et al [22] n/a n/a n/a Aydogan et al [23] Yes Surgery 26 months follow-up…”

“…Verrucous carcinoma is a rare variant of squamous cell carcinoma that presents in the head and neck with the most common sites being the oral cavity and larynx [1][2][3][4][5][6][7][8]. It is so uncommon, in fact, that verrucous carcinoma composes only 5% of tumors at these sites [2,14].…”

“…The presence of submucous fibrosis and leukoplakia are associated with poor outcomes [15]. Verrucous carcinoma extremely rarely involves the temporal bone, and only 14 cases have been reported in literature [3,[16][17][18][19][20][21][22][23][24]. Because so few cases of verrucous carcinoma involving the middle ear and temporal bone have been described, there is no consensus on the best course of treatment for these lesions.…”

Verrucous carcinoma: a retrospective diagnosis in three historic patients

“…Verrucous carcinoma was not recognized in Europe until the 1976 report of Ferlito [3] classifying 2,052 malignant neoplasms of the larynx and hypopharynx treated at the University of Padua. The tumor is often referred to as ''Ackerman's tumor'' in his honor [4].…”