Plantar verrucous carcinoma. Literature review and treatment by the Mohs' chemosurgery technique

Abstract

Verrucous carcinoma, a variant of squamous cell carcinoma, is recognized as a distinct clinicopathologic entity. It occurs principally in three anatomic sites: panoral, genitogluteal, and plantar. Two cases of plantar verrucous carcinoma treated by the Mohs' chemosurgery technique are reported, and the literature is reviewed. The clinical and pathologic appearance of these lesions make them recognizable in a patient with a persistent plantar lesion usually diagnosed as a wart but unresponsive to conventional therapy. The role of irradiation, a possible viral etiology of the tumor, and the necessity for a deep biopsy are discussed. Because these tumors are characterized by extensive local growth, Mohs' chemosurgery is proposed as the treatment of choice. In this way, total tumor ablation is obtained with maximum preservation of normal tissue structure and function.

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

“…25,56 The efficacy of MMS is well documented for tumors with contiguous growth and enables maximum preservation of normal tissue structure and function with complete margin visualization. Thus, our results are in agreement with those of prior studies, [54][55][56]64 suggesting that MMS is associated with lower recurrence rates for EC than WLE. Future studies and reporting of MMS for EC are particularly important because of the functional importance of the plantar foot.…”

Plantar Verrucous Carcinoma: Report of a Case Treated with Boyd Amputation Followed by Reconstruction with a Free Forearm Flap

“…Successful treatment requires complete excision, and most surgeons have treated these tumors with wide excision or amputation, depending on the extent of involvement (1, 8, 13). Mohs'chemosurgery technique has become a useful option for surgical therapy (20–23). Radiation therapy is not indicated for this tumor because of the potential for malignant transformation and metastasis (24).…”

Verrucous carcinoma of the ear following renal transplantation: a case report and review of the literature

“…The usual locations of this rare tumor are the oral cavity, larynx, genital region [7,18], perianal skin [25], and the foot [1,16,25,28]. Other very rare locations include the leg [30], buttock, hand [16], and amputation stump [16,26].…”

“…The lesion may be clinically misdiagnosed and treated as a wart [16,28]. Most of the difficulty can be attributed to this tumor's very slow growth and its deceptively benign cytological features, characteristics that have often resulted in a considerable delay in establishing the correct diagnosis [23].…”