Verrucous carcinoma of the vagina

Verrucous carcinoma of the female genital tract: report of a case and review of the literature

Verrucous carcinoma (VC) of the female genital tract is a rare lesion, primarily affecting postmenopausal women. A case of VC of the vulva is reported, bringing the total number of VC of the female genital tract to 89. VC is a slowly growing, locally "pushing" tumor with a rather benign histologic appearance, and the clinical and histologic characteristics are described on the basis of the present report and a review of the literature. The treatment of VC is still a matter of discussion. It seems logical to treat the tumor by wide local excision, taking the lack of proof of spontaneous metastasis into consideration. Radiation therapy should be contraindicated, and local application of podophyllin, bleomycin therapy, and cryosurgery are ineffective methods in the treatment of VC.

Primary surgical treatment in one hundred ninety-five cases of stage IB carcinoma of the cervix

Stage IB carcinoma of the cervix may be treated primarily by either radiotherapy of operation. A primary surgical approach was used in 95 patients for the following indications: young age with desire to retain ovarian function (124), pelvic inflammatory disease (33), pregnant or post partum (15), refusal of radiotherapy (11), anatomic problems contraindicating radiotherapy (10), undiagnosed pelvic mass (seven), verrucous tumor (three), mucus-secreting tumor (two), syphilis (one), and previous radiotherapy for Hodgkin's disease (one). Twelve patients had two indications. The surgical procedures were radical abdominal hysterectomy and pelvic lymph node dissection (191) and Schauta-Amreich (radical vaginal) hysterectomy (4). Fourteen patients had serious postoperative complications. The uncorrected 5-year survival rate (95.1% follow-up) was 91.1%. The rationale for recommending a primary surgical approach to selected patients with Stage IB cervical carcinoma is presented.

Verrucous carcinoma of the oral cavity. A review of forty-nine cases

Verrucous carcinoma is a distinctive, extremely well-differentiated, slow-growing variant of the squamous cell carcinoma. Forty-nine cases of this neoplasm were gathered from the Oral Pathology Service at the Emory University School of Dentistry from 1965 to 1979. The most common site of occurrence was the buccal mucosa, followed by the mandibular alveolar ridge and gingiva. The majority of our patients were between the ages of 50 and 80 years, and most of them were Caucasians. Although most other series of oral verrucous carcinoma show a male predominance, almost 60 percent of our cases occurred in females. The role of radiation therapy in treatment of oral verrucous carcinoma is controversial, and adequate surgical excision appears to be the treatment of choice.

Verrucous squamous cell carcinoma of the female genital tract. Report of three cases and survey of the literature

Three new cases of gynecological verrucous squamous cell carcinomas are reported; one in the uterine cervix, and two in the vulva. The English literature covering the 49 cases reported previously is surveyed with special reference to the diagnostic and therapeutic aspects of these tumors, as well as with their clinical behavior and possible relationship to viral (HPV) lesions (Condylomas) of the genital tract. It was concluded that so far the exact relationship between the different verrucous squamous cell lesions in the genital tract remains obscure, all such lesions should be regarded as potentially malignant, and treated accordingly by radical surgery.

Ackerman's tumor (verrucous carcinoma) of the larynx: a clinicopathologic study of 77 cases

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 reponses 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 of urinary bladder

The authors have encountered a recent case of verrucous carcinoma of the urinary bladder in a seventy-three-year-old man. The difference in its clinical presentation and pathologic growth pattern from the usual squamous cell carcinoma is striking. The case report, a detailed pathologic description of the lesion, and review of the scanty literature are presented.

Verrucous lesions of the female genitalia. II. Verrucous carcinoma

Verrucous carcinoma is a variant of squamous cell carcinoma that often presents as a large cauliflower-like lesion with locally destructive growth. A high index of suspicion on the part of the clinician and pathologist is needed for an accurate diagnosis since the pathologic findings may be benign on an individual cell basis or may even resemble those of a condyloma. Deep biopsy that includes the base of the lesion is needed for accurate histologic diagnosis, and the pathologist should be aware of the aggressive nature of the lesion. The treatment of choice is surgical, with wide local excision being sufficient in most cases. Radiotherapy often fails to eradicate the lesion and may even cause it to become more anaplastic.