Synonyms

Condylomatous carcinoma
Verrucous squamous cell carcinoma
Verrucous epidermoid carcinoma
Warty carcinoma

Definitions

Esophagus
ICD-O-3 topography code:	C15
ICD10:	C15

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins.

In the oesophagus, verrucous carcinoma is an extremely rare, distinct, highly differentiated variant of squamous cell carcinoma (SCC). It is usually associated with chronic oesophagitis, achalasia, diverticular disease, or gastro-oesophageal reflux disease ¹

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Kavin H, Yaremko L, Valaitis J, Chowdhury L (1996)
Chronic esophagitis evolving to verrucous squamous cell carcinoma: possible role of exogenous chemical carcinogens.
Gastroenterology 110: 904-14

. Microscopically, it consists of highly differentiated keratinized cells with minimal cytological atypia. The tumour shows a pushing rather than an infiltrating margin ²

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Osborn NK, Keate RF, Trastek VF, Nguyen CC (2003)
Verrucous carcinoma of the esophagus: clinicopathophysiologic features and treatment of a rare entity.
Dig Dis Sci 48: 465-74

, growing slowly and invading locally. Metastases are uncommon ³

Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010

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Anus and anal canal
ICD-O-3 topography code:	C21
ICD10:	C21

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.

Verrucous carcinoma of the anal canal
In the anogenital area, this tumour is also called giant (malignant) condyloma or Buschke-L?wenstein tumour ⁴

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Grussendorf-Conen EI (1997)
Anogenital premalignant and malignant tumors (including Buschke-Löwenstein tumors).
Clin Dermatol 15: 377-88

. It has a cauliflower-like appearance, is larger than the usual condyloma (with a diameter of up to 12 cm), and fails to respond to conservative treatment. In contrast to an ordinary condyloma, it is characterized by a combination of exophytic and endophytic growth.

Histologically, it shows acanthosis and papillomatosis with orderly arrangement of the epithelial layers and an intact but often irregular base with blunt downward projections and keratin-filled cysts. The endophytic growth may represent invasive activity, but convincing evidence of invasive growth is rare. Cytologically, the epithelial cells appear benign. Large nuclei with prominent nucleoli may be present, but cytonuclear atypia is usually minimal and mitoses are restricted to the basal layers ⁵

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Longacre TA, Kong CS, Welton ML (2008)
Diagnostic problems in anal pathology.
Adv Anat Pathol 15: 263-78

.

Some verrucous carcinomas contain HPV, the most common types being HPV6 and HPV11. They are regarded as an intermediate state between the ordinary condyloma and SCC, and the clinical course is typically that of local destructive invasion without metastases ⁶

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Bertram P, Treutner KH, Rübben A, Hauptmann S, Schumpelick V (1995)
Invasive squamous-cell carcinoma in giant anorectal condyloma (Buschke-Löwenstein tumor).
Langenbecks Arch Chir 380: 115-8

⁷

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Longacre TA, Kong CS, Welton ML (2008)
Diagnostic problems in anal pathology.
Adv Anat Pathol 15: 263-78

. The presence of severe cytological changes, unequivocal invasion or metastases should lead to the diagnosis of SCC and to the appropriate therapy.

Skin
ICD-O-3 topography code:	C44
ICD10:	C44

Verrucous squamous cell carcinoma is a well differentiated variant of squamous cell carcinoma histologically characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumour margins. An important diagnostic clue is the presence of neutrophils, which may form small abscesses within the epidermis.
The lesions usually penetrate deeply below the level of the surrounding epidermis / mucosa. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.
Verrucous squamous cell carcinoma occurs predominantly in adult men. The prognosis after complete excision is excellent; after inadequate excision, the recurrence rate is high and the survival decreases ⁸

LeBoit PE, Burg G, Weedon D, Sarasin A (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Skin Tumours
3rd Edition
IARC Press: Lyon 2005

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Nasal cavity and Sinuses
ICD-O-3 topography code:	C30-C31
ICD10:	C30-C31

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.

Lip, Oral Cavity and Oropharynx
ICD-O-3 topography code:	C00-C06, C09-C10, C14
ICD10:	C00-C06, C09-C10, C14

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.

Hypopharynx, Larynx and Trachea
ICD-O-3 topography code:	C13, C32, C33
ICD10:	C13, C32, C33

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.

Penis
ICD-O-3 topography code:	C60
ICD10:	C60

A well differentiated squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, mild cytologic atypia, and pushing tumor margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.

Cervix uteri
ICD-O-3 topography code:	C53
ICD10:	C53

/span>errucous carcinoma is a well differentiated histological variant of squamous cell carcinoma characterized by a papillary growth pattern, acanthosis, minimal nuclear atypia, and pushing tumour margins. The most commonly affected anatomic sites are the oral cavity, nasal cavity, larynx, esophagus, anus, vagina, vulva, and the plantar region of the foot.
Verrucous carcinoma of the uterine cervix shows no evidence of HPV infection. Cervical squamous cell carcinoma with a warty surface and cellular features of HPV infection is termed > >Tavassoli FA, Devilee P (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs.
3rd Edition
IARC Press: Lyon 2003