An unusual case of bilateral verrucous carcinoma of the foot (epithelioma cuniculatum)

Squamous Cell Carcinoma of the Foot Occurring in a Wart

Verrucous carcinoma is a rare form squamous cell carcinoma which appears similar to a wart. When it occurs in the feet, it can be easily misdiagnosed. It rarely metastasizes or recurs posttreatment. We report a case of a septuagenarian with recurrence of verrucous carcinoma diagnosed within 6 months at the site of previous treatment. Unique features in our patient's clinical presentation include his advanced age, being nondiabetic, and the rapid recurrence of carcinoma.Level of Evidence: Level IV: Case report.

Mistaken Diabetic Ulcers: A Case of Bilateral Foot Verrucous Carcinoma

Verrucous carcinoma (VC) is a rare, low-grade, and well-differentiated variant of squamous cell carcinoma. These tumors are slow-growing and exophytic and have a negligible incidence of metastasis. Treatment is complete surgical resection, ideally by Mohs micrographic surgery, to ensure adequate clear margins. Cutaneous VC predominantly occurs on the plantar surface of the foot and rarely occurs in multiple sites. This case study describes the fourth reported occurrence of bilateral VC of the feet in a woman with chronic diabetic foot ulcers. The case provides further support for persistent wounds contributing to the development of this lesion and describes their role in the characteristic delay in diagnosis of VC.

Verrucous Carcinoma - Observations on 4 Cases

Verrucous carcinoma (VC) is a rare well-differentiated squamous cell carcinoma with the clinical forms: oral florid papillomatosis, epithelioma cuniculatum, papilomatosis cutis and Buschke-Löwenstein tumor. We present four patients and the four clinical forms of CV. The diagnosis we held after clinical examination and histopathological examination of the balance sheet expansion. First described by Ackermanin the oral mucosal, today it has a reported incidence of 1-3 cases per million inhabitants. CV can involve both skin and mucous membranes. Etiopathogenesis is uncertain, but participation HPV is widely accepted. WHO recognizes the CV as a rare form of well-differentiated squamous cell carcinoma with slow and continues evolution, with the invasion of underlying tissues, frequent relapses and very low risk of metastasis. The elective therapy is surgical excision with safety oncological margins. Diagnosis involves corroboration of clinical data with histopathological appearance and evolutive behavior of the tumor. Given the increased risk for recurrence, the patient should be reviewed quarterly to finding healing.

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

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.