Asian Oncology Research Journal

A Case Report and Literature Review of Verrucous Carcinoma of the Anus

Irfan Rasool Gadda *

Department of Radiation Oncology, Government Medical College, Srinagar, India.

Umar Farooq Bhat

Department of Radiation Oncology, Government Medical College, Srinagar, India.

*Author to whom correspondence should be addressed.

---

Abstract

Low-grade verrucous exophytic squamous cell carcinomas are uncommon. In 1948, Lauren identified a subtype of squamous cell carcinoma known as verrucous carcinoma (VC). Verrucous carcinoma develops rather slowly, and lymph node metastasis and distant metastases are uncommon. Local recurrences can be related to verrucous carcinoma. In most cases, verrucous carcinoma expands via direct extension. Here we present a case of 50 years male smoker who presented with perianal swelling. The patient underwent a biopsy and histopathology was suggestive of verrucous carcinoma with a focus on well-differentiated Squamous cell carcinoma. MRI pelvis done on 25.12.2021 was suggestive of large poorly marginated infiltrating mass lesion measuring 71x58x 42 mm centred in the skin and subcutaneous planes of left perianal region focally extending into left ischioanal fossa closely abutting the external sphincter at 3-4 0 clock position below the levator plane. No extension into inter sphincteric and supra levator area was seen. Enbloc excision of the perianal tumour with iliac and inguinal node dissection was done, the patient had recurrence after 1 year and repeat surgery was done, Post-surgery scans were suggestive of residual disease and locally advanced disease. The patient was subjected to chemotherapy and is now on follow-up.

Keywords: Verrucous carcinomas, squamous cell carcinoma, recurrence

---

---

---

References

Ackerman LV. Verrucous carcinoma of the oral cavity. Surgery. 1948;23(4):670-8.

Hoang LN, Park KJ, Soslow RA, Murali R. Squamous precursor lesions of the vulva: current classification and diagnostic challenges. Pathology. 2016;48:291- 302.

Nascimento AF, Granter SR, Cviko A, Yuan L, Hecht JL, Crum CP. Vulvar acanthosis with altered differentiation: a precursor to verrucous carcinoma? Am J SurgPathol. 2004;28:638- 643.

Gadducci A, De Punzio C, Facchini V, Rispoli G, Fioretti P. The therapy of verrucous carcinoma of the vulva: observation on three cases. Eur J GynaecolOncol. 1989;10(4):284-7.

Lever WF. Histopathology of the skin, 7th ed, Philadelphia. 1990:558

Soos Z, Varga T, Vadinszky P, Hajos P, Vajda K, Kiss S, et al. Verrucous carcinoma of the anal margin. The importance of adequate biopsy technique. OrvHetil. 2011;152(9):344-8.

Zidar N, Langner C, Odar K, Hosnjak L, Kamarádova K, Daum O, et al. Anal verrucous carcinoma is not related to infection with human papillomaviruses and should be distinguished from giant condyloma (Buschke-Lowenstein tumour). Histopathology. 2017;70(6):938-45.

Elliott GB, MacDougall JA, Elliott JD: Problems of verrucose squamous carcinoma. Ann Surg1973;177:21-8.

Demian SD, Bushkin FL, Echevarria RA. Perineural invasion and anaplastic transformation of verrucous carcinoma, Cancer.1973;32(2):395–401.

Oh K, Nishigami T, Takubo K, Shimada Y, Fujimoto J. A case of verrucous squamous cell carcinoma of the oesophagus. Esophagus. 2009;6(4):263-7.

Japaze H, Van Dinh T, Woodruff JD. Verrucous Carcinoma of the Vulva: study of 24 cases. Obstet Gynecol. 1982; 60(4):462-6.

Schwartz RA. Verrucous carcinoma of the skin and mucosa. J Am AcadDermatol. 1995;32(1):1-21.