Atypical Presentation of Verrucous Carcinoma

Penera, Keith; Manji, K; Craig, Alex B.; Grootegoed, Rebecca A.; Leaming, Troy R.; Wirth, Garrett A.

doi:10.1177/1938640013489341

Cited by 20 publications

(19 citation statements)

References 65 publications

(89 reference statements)

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“…Carcinoma cuniculatum is a rare, locally invasive squamous cell carcinoma with a low grade of malignancy [ 1 ]. It is rare with only about 100 cases reported so far, with the first report by Aird et al [ 1 ] in 1954 [ 4 ]. It occurs in older patients, with at average age at diagnosis of about 60 years, and with a higher prevalence in men as compared to women.…”

Section: Discussionmentioning

confidence: 99%

“…After excision, reconstruction of the surgical wound is often a challenge because of the extent and location of the tumor. Primary, secondary, and delayed closure techniques, skin grafts, and flaps have been suggested for larger skin defects [ 4 , 6 ]. Other conservative therapeutic approaches, for example, electrodesiccation, cryotherapy, and laser ablation, are not always effective and often result in tumor recurrence [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Carcinoma Cuniculatum of the Foot Invading the Bone Mimicking a Pseudo-Epitheliomatous Reaction to an Acute Osteomyelitis

Arisi

Zane

Edu

et al. 2015

Dermatol Ther (Heidelb)

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Carcinoma cuniculatum is a rare variant of squamous cell carcinoma. The clinical presentation is usually a non-verrucous exophytic plaque or tumor of the plantar region with a penetration in the deep tissues. Histological examination shows a proliferation of well-differentiated keratinocytes. We describe a patient affected by a slowly enlarging tumoral lesion overlying the fifth metatarsum of the left foot. Clinical examination and radiological investigations suggested a chronic osteomyelitis and a first histological examination of a punch biopsy was suggestive of a pseudo-epitheliomatous hyperplasia. The patient underwent several cycles with systemic antibiotics without improvement. Finally, the fifth metatarso was amputated and the skin lesion was completely removed. The histological examination of the whole operatory mass allowed a diagnosis of carcinoma cuniculatum invading the bone.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-015-0090-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carcinoma Cuniculatum of the Foot Invading the Bone Mimicking a Pseudo-Epitheliomatous Reaction to an Acute Osteomyelitis

Arisi

Zane

Edu

et al. 2015

Dermatol Ther (Heidelb)

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“…One review found no recurrences in 5 cases of EC treated with MMS. 23 As MMS is a tissue-sparing technique, this is a valuable modality for sites of functional importance such as the feet. Herein, we review various reported EC treatment modalities and outcomes, with an emphasis on recurrence rates for WLE and MMS.…”

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confidence: 99%

Epithelioma Cuniculatum (Plantar Verrucous Carcinoma): A Systematic Review of Treatment Options

Daniel¹

2023

Cutis

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CLINICAL REVIEWEpithelioma cuniculatum (EC) is a subtype of verrucous carcinoma (VC) that affects the feet. Treatment involves complete tumor removal by wide local excision (WLE) or Mohs micrographic surgery (MMS). Extensive local destruction may require amputation. We sought to compare reported treatment methods for EC and determine their efficacy by assessing for tumor recurrence and treatment-associated complications. A systematic review of the literature spanning multiple databases was performed. To date, surgical excision is recommended as the standard of care for treatment of EC, with amputation considered in more advanced cases. Mohs micrographic surgery appears to be a promising treatment modality for EC and may have lower recurrence rates than WLE but requires further investigation.Cutis. 2023;111:E19-E24.V errucous carcinoma (VC) is an uncommon type of well-differentiated squamous cell carcinoma (SCC) that most commonly affects men in the fifth to sixth decades of life. 1 The tumor grows slowly over a decade or more and does not frequently metastasize but has a high propensity for recurrence and local invasion. 2 There are 3 main subtypes of VC classified by anatomic site: oral florid papillomatosis (oral cavity), Buschke-Lowenstein tumor (anogenital region), and epithelioma cuniculatum (EC)(feet). 3 Epithelioma cuniculatum, also known as carcinoma cuniculatum or papillomatosis cutis carcinoides, most commonly presents as a solitary, warty or cauliflowerlike, exophytic mass with keratin-filled sinus tracts and malodorous discharge. 4 Diabetic foot ulcers and chronic inflammatory conditions are predisposing risk factors for EC, and it can result in difficulty walking/immobility, pain, and bleeding depending on anatomic involvement. [5][6][7][8][9] The differential diagnosis for VC includes refractory verruca vulgaris, clavus, SCC, keratoacanthoma, deep fungal or mycobacterial infection, eccrine poroma or porocarcinoma, amelanotic melanoma, and sarcoma. [10][11][12][13] The slow-growing nature of VC, sampling error of superficial biopsies, and minimal cytological atypia on histologic examination can contribute to delayed diagnosis and appropriate treatment. 14 Characteristic histologic features include hyperkeratosis, papillomatosis, marked acanthosis, broad blunt-ended rete ridges with a "bulldozing" architecture, and minimal cytologic atypia and mitoses. 5,6

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“…Verrucous carcinoma is a rarely occurring, low-grade variant of squamous cell carcinoma, slow-growing verrucous and with minimal dysplasia. [ 1 ] The incidence of epithelioma cuniculatum is unknown, with a predominance for men in their fifth–sixth decades. [ 2 ] It occurs most commonly on the ball of the sole (53%), followed by the toes (21%) and heel (16%).…”

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confidence: 99%

“…Metastasis from CC is rare, although it can invade deep into the soft tissues and can extend to tendons, muscles, or bone. [ 1 4 ] We report a case of a 67-year-old healthy man with 10 years history of enlarging cauliflower-like lesion of his right heel, initially diagnosed and treated as a wart. During the years, the lesion has grown progressively despite treatment until becoming a deeply penetrating mass, 6 cm × 5 cm × 3 cm, with an exophytic and hyperkeratotic component [ Figure 1a ].…”

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confidence: 99%