Sandbox: Verrucous carcinoma: Difference between revisions
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==Overview== | ==Overview== | ||
'''Verrucous carcinoma''' (also known as "Snuff dipper's cancer") is rare subtype of [[squamous cell carcinoma]].<ref>Ridge JA, Glisson BS, Lango MN, et al. [http://www.cancernetwork.com/cancer-management-11/chapter04/article/10165/1402663 "Head and Neck Tumors"] in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) [http://www.cancernetwork.com/cancer-management-11/ Cancer Management: A Multidisciplinary Approach]. 11 ed. 2008.</ref> Common causes of verrucous carcinoma, include: [[tobacco]] chewing, or use [[Snuff (tobacco)|snuff]] orally. Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia. The oral cavity is the most common site of this tumor.<ref>Medina JE, Dichtel W, Luna MA. Verrucous-squamous carcinoma of the oral cavity: a clinicopathologic study of 104 cases. Arch Otolaryngol 1984;110:437-40</ref> Verrucous carcinoma is most commonly seen among male patients between 50 to 80 years, and the median age at diagnosis is 67 years.<ref>Tornes K, Bang G, Koppang HS, Pedweson KN. Oral verrucous carcinoma. Int J Oral Surg 1985;14:485-92</ref> <ref>Koch BB, Trask DK, Hoffman HT, Karnell LH, Robinson RA, Zhen W, Menck HR. National survey of head and neck verrucous carcinoma. Cancer 2001;92:110-20</ref> The diagnosic criteria for verrucous carcinoma is | '''Verrucous carcinoma''' (also known as "Snuff dipper's cancer") is rare subtype of [[squamous cell carcinoma]].<ref>Ridge JA, Glisson BS, Lango MN, et al. [http://www.cancernetwork.com/cancer-management-11/chapter04/article/10165/1402663 "Head and Neck Tumors"] in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) [http://www.cancernetwork.com/cancer-management-11/ Cancer Management: A Multidisciplinary Approach]. 11 ed. 2008.</ref> Common causes of verrucous carcinoma, include: [[tobacco]] chewing, or use [[Snuff (tobacco)|snuff]] orally. Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia. The oral cavity is the most common site of this tumor.<ref>Medina JE, Dichtel W, Luna MA. Verrucous-squamous carcinoma of the oral cavity: a clinicopathologic study of 104 cases. Arch Otolaryngol 1984;110:437-40</ref> Verrucous carcinoma is most commonly seen among male patients between 50 to 80 years, and the median age at diagnosis is 67 years.<ref>Tornes K, Bang G, Koppang HS, Pedweson KN. Oral verrucous carcinoma. Int J Oral Surg 1985;14:485-92</ref><ref>Koch BB, Trask DK, Hoffman HT, Karnell LH, Robinson RA, Zhen W, Menck HR. National survey of head and neck verrucous carcinoma. Cancer 2001;92:110-20</ref> The diagnosic criteria for verrucous carcinoma is | ||
Biopsy and surgical excision must provide adequate specimens including the full thickness of the tumors and adjacent uninvolved mucosa for correct diagnosis.<ref>McDonald JS, Crissman JD, Gluckman JL. Verrucous Carcinoma of the oral cavity. Head Neck Surg 1982;5:22-8</ref> | Biopsy and surgical excision must provide adequate specimens including the full thickness of the tumors and adjacent uninvolved mucosa for correct diagnosis.<ref>McDonald JS, Crissman JD, Gluckman JL. Verrucous Carcinoma of the oral cavity. Head Neck Surg 1982;5:22-8</ref> | ||
Revision as of 14:27, 11 May 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Synonyms and keywords:
Overview
Verrucous carcinoma (also known as "Snuff dipper's cancer") is rare subtype of squamous cell carcinoma.[1] Common causes of verrucous carcinoma, include: tobacco chewing, or use snuff orally. Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma. Verrucous carcinoma may occur in various head and neck locations, as well as in the genitalia. The oral cavity is the most common site of this tumor.[2] Verrucous carcinoma is most commonly seen among male patients between 50 to 80 years, and the median age at diagnosis is 67 years.[3][4] The diagnosic criteria for verrucous carcinoma is Biopsy and surgical excision must provide adequate specimens including the full thickness of the tumors and adjacent uninvolved mucosa for correct diagnosis.[5]
Historical Perspective
- Verrucous carcinoma was first discovered by Lauren V. Ackerman, an American physician in 1948.
Classification
- Verrucous carcinoma may be classified into 5 subtypes:
- Epithelioma cuniculatum (Ackerman tumor, carcinoma cuniculatum)
- Buschke–Löwenstein tumor (giant condyloma)
- Oral florid papillomatosis
- Subungual keratoacanthoma
- Gottron's carcinoid papillomatosis
Pathophysiology
- The pathogenesis of verrucous carcinoma is characterized as a well-differentiated squamous cell carcinoma with minimal metastatic potential.
- Different locations of verrucous carcinoma, include:
- Gingiva
- Buccal mucosa
- Alveolar mucosa
- Hard palate
- Floor of the mouth
- Larynx
- Esophagus
- Penis
- Vagina
- Scrotum
- There are no genetic mutations associated with the development of verrucous carcinoma.
- On gross pathology, characteristic findings of verrucous carcinoma include:
- Cauliflower-like, exophytic mass
- On microscopic histopathological analysis, characteristic findings of verrucous carcinoma include:
- Exophytic growth
- Well-differentiated
- "Glassy" appearance
- Pushing border - described "elephant feet"
Causes
- Common causes of verrucous carcinoma, include:
- Use snuff orally
- Tobacco chewing
- Chewing betel nuts (Taiwan)
- Alcohol consumption
Differentiating Verrucous Carcinoma from Other Diseases
- Verrucous carcinoma must be differentiated from other diseases that cause leukoplakic patches, such as:
- Keratoacanthoma
- Giant verruca vulgaris
- Nongenital warts
- Pyoderma vegetans
Epidemiology and Demographics
- Verrucous carcinoma is very uncommon
Age
- Verrucous carcinoma is more commonly observed among patients aged 50 to 80 years old.
- Verrucous carcinoma is more commonly observed among middle-aged and elderly adults.
Gender
- Males are more commonly affected with verrucous carcinoma than females.
Race
- There is no racial predilection for verrucous carcinoma.
Risk Factors
- Common risk factors in the development of verrucous carcinoma, include:
Natural History, Complications and Prognosis
- The majority of patients with verrucous carcinoma remain asymptomatic for years.
- Early clinical features include
- If left untreated, patients with verrucous carcinoma may progress to develop malignant transformation.
- Common complications of verrucous carcinoma, include:
- Prognosis is generally good, and the 5-survival rate] of patients with verrucous carcinoma is approximately
Diagnosis
Diagnostic Criteria
- The diagnosis of verrucous carcinoma is made with the following diagnostic criteria:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- Verrucous carcinoma is usually asymptomatic.
- Symptoms of verrucous carcinoma may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
Physical Examination
- Patients with verrucous carcinoma usually appear malnourished.
- Physical examination may be remarkable for:
- Slow growing, diffuse, exophytic lesion
- Leukoplakic patches
- Enlarged regional lymph nodes.
- Painful multiple rugae-like folds and deep clefts.
Laboratory Findings
- There are no specific laboratory findings associated with verrucous carcinoma.
Imaging Findings
- [Imaging study 1] is the imaging modality of choice for verrucous carcinoma.
- On [imaging study 1], verrucous carcinoma is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- Verrucous carcinoma may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- The mainstay of therapy for verrucous carcinoma, includes:
Surgery
- Surgery is the mainstay of therapy for verrucous carcinoma.
- Surgical excision in conjunction with laser therapy is the most common approach to the treatment of verrucous carcinoma.
Prevention
- There are no primary preventive measures available for verrucous carcinoma.
- Effective measures for the primary prevention of verrucous carcinoma include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with verrucous carcinoma are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ Ridge JA, Glisson BS, Lango MN, et al. "Head and Neck Tumors" in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) Cancer Management: A Multidisciplinary Approach. 11 ed. 2008.
- ↑ Medina JE, Dichtel W, Luna MA. Verrucous-squamous carcinoma of the oral cavity: a clinicopathologic study of 104 cases. Arch Otolaryngol 1984;110:437-40
- ↑ Tornes K, Bang G, Koppang HS, Pedweson KN. Oral verrucous carcinoma. Int J Oral Surg 1985;14:485-92
- ↑ Koch BB, Trask DK, Hoffman HT, Karnell LH, Robinson RA, Zhen W, Menck HR. National survey of head and neck verrucous carcinoma. Cancer 2001;92:110-20
- ↑ McDonald JS, Crissman JD, Gluckman JL. Verrucous Carcinoma of the oral cavity. Head Neck Surg 1982;5:22-8