Many cases of verrucous carcinoma occur in the setting of scars, amputations, and chronic inflammation. Subtypes of verrucous carcinoma are seen in particular anatomic locations:
Localized Areas of Tumor Presentation:
- Plantar foot (epithelioma cuniculatum) – Commonly develops on the ball of the foot; can destroy underlying bony structures.
- Oral cavity (oral verrucous carcinoma, Ackerman tumor) – See Verrucous carcinoma – Oral Mucosal Lesion.
- Anogenital region (giant condyloma of Buschke-Loewenstein) – Typically more aggressive; consider underlying immunosuppression. See Buschke-Lowenstein tumor.
- Nail bed (rare) – Onycholysis and shedding of the nail plate are at times present.
C44.320 – Squamous cell carcinoma of skin of unspecified parts of face
D04.9 – Carcinoma in situ of skin, unspecified
89906000 – Verrucous Carcinoma
- Verruca vulgaris (common wart) – Look for black dots indicating thrombosed vessels on paring.
- Cutaneous squamous cell carcinoma – Differentiated on histology based on cellular atypia, invasive growth pattern, and mitotic activity.
- Amelanotic melanoma – Usually faster growing than verrucous carcinoma.
- Deep fungal infections – Characteristic geographic locations for coccidioidomycosis and blastomycosis may raise suspicion.
- Halogenoderma (bromoderma, iododerma) – If patients take medications containing bromine or iodine or have a history of ingestion or a recent radiology procedure.
- Epidermal inclusion cyst – May see a single center punctum that occasionally drains curdy, white material.
- Other epidermal and adnexal tumors – Multiple benign and malignant tumors may be clinical mimickers based on the location of the tumor, including seborrheic keratosis and poroma.