Verrucous carcinoma arising in ulcerative lichen planus of the soles

Verrucous carcinoma is a low-grade squamous cell carcinoma. Chronic inflammation is an important factor in its pathogenesis. This is the first case of plantar verrucous carcinoma arising in a lesion of ulcerative lichen planus. This paper also lends further support to the successful use of Mohs micrographic surgical technique as the treatment of choice for verrucous carcinoma.     

The association of lichen planus of the penis with squamous cell carcinoma in situ and with verrucous squamous carcinoma

Two cases of squamous cell carcinoma (SCC) of the penis, one verrucous type and one in situ, arising in association with an inflammatory dermatosis most consistent with lichen planus, are described. Although SCC has previously been reported to have arisen from lichen planus of the oral mucosa, these are the first reported cases of the coexistence of these processes on the penis.     

Meet the expert: Topical management of vulvar dermatoses

Vulvar dermatoses are often debilitating chronic skin conditions associated with pain and pruritus. In oncologic patients, cancer treatments can precipitate and exacerbate vulvar dermatoses. Cytotoxic chemotherapy, hormonal therapies, and local pelvic radiation therapy can lead to vulvar symptoms, and cancer treatment-induced vulvar conditions include graft-versus-host-disease and radiation dermatitis. There have also been reports of lichen sclerosus development or exacerbation secondary to hormonal therapy and immune checkpoint inhibitors, attributed to proposed hormonal and immunologic pathogenesis of lichen sclerosus. Early recognition and treatment of these conditions can significantly improve quality of life. In this review, we summarize the clinical features and management characteristics of six types of common vulvar dermatoses that may present in the oncologic patient.     

阴茎疣状癌的诊断及治疗

目的：探讨阴茎疣状癌的临床诊断及治疗方法。方法回顾性分析1例阴茎疣状癌的临床诊治过程,并结合相关文献进行复习。结果阴茎疣状癌的临床表现及其诊断治疗方法不同于普通阴茎鳞癌,常被误诊为局部感染病灶或低度鳞状细胞癌,明确诊断主要依据病理检查。结论阴茎疣状癌为临床罕见病例,易误诊,手术治疗是其有效治疗手段。     

Prevention,identification and treatment of vulvar squamous (pre)malignancies: a review focusing on quality of care

Vulvar squamous cell carcinoma, its precursor lesions (usual and differentiated vulvar intraepithelial neoplasia) and lichen sclerosus are rare diseases that may have a large impact on the lives of affected women and their partners. Proper identification is vital, but the lesions are sometimes difficult to diagnose because of their rarity and variety of symptoms. High quality of care and proper treatment is important in order to minimize the morbidity and mortality caused by these lesions. This review gives an outline of the latest insights regarding the current evidence in this area and unresolved issues. Additionally, it highlights the improvements that should be made in order to optimize prevention and identification of (pre-)malignant vulvar lesions and to increase the quality of care for these patients.     

Cytologically malignant squamous-cell carcinoma arising in a verrucous carcinoma of the penis

A case of verrucous carcinoma with a focus of cytologically malignant squamous-cell carcinoma is presented. This usually occurs following radiation therapy of the verrucous carcinoma, but may rarely occur de novo, as in this case. The potential usefulness of fine-needle aspiration in detecting focal anaplasia in verrucous carcinoma is discussed. This technique may be especially useful if the lesion is to be destroyed cryosurgically.     

Proliferative verrucous leukoplakia and its related lesions

Proliferative verrucous leukoplakia (PVL) is a unique type of clinical oral leukoplakia. Enigmatic in etiology, PVL behaves in a far more aggressive fashion than other forms of leukoplakia. Its aggressiveness relates not only to a high recurrence rate, but more so to a very high level of and relentless progression from a localized simple keratosis to extensive oral disease and squamous carcinomas of verrucous, or conventional squamous cell type. Diagnosis is often late in the protracted course of PVL with the disease in an advanced stage when it is especially refractory to treatment. Within the histologic spectrum that is seen in PVL, usually as a function of time, are: (1) verrucous hyperplasia (VH), a histologically defined lesion; (2) varying degrees of dysplasia; and (3) three forms of squamous cell carcinoma: verrucous, conventional and, according to some, papillary squamous cell carcinoma. Each of these are discussed both within and outside the context of PVL. VH is a forerunner of verrucous carcinoma and the transition is so consistent that the hyperplasia, once diagnosed, should be treated like verrucous carcinoma. VH is not only an oral lesion; it can occur in the upper airway (sinonasal tract and larynx) where it is not usually found within a maternal soil of PVL. Papillary squamous cell carcinoma has been a loosely defined neoplasm, more often considered a verrucal type of malignancy. It nonetheless is a distinct clinicopathologic entity, separate from verrucous carcinoma and without a predilection for the oral cavity or an association with PVL.     

Chemosurgery for verrucous carcinoma

The first cases of verrucous carcinoma treated by chemosurgery are herewith reported. We classify verrucous carcinoma in variants according to site as pan-oral, genito-gluteal, and plantar. Chemosurgery is advocated as the treatment of choice for verrucous carcinoma because ablation, being microscopically monitored, is most likely to be complete, and because by this means maximal conservation of tissue is assured.     

Pathological and clinical analysis of 102 cases of lip carcinoma

102 cases (103 tumors) of lip carcinoma treated by surgery are analyzed. There were 37 (35.9%) verrucous carcinoma and 66 (64.1%) squamous cell carcinoma which included grade I 29 cases, grade II 21, grade III 14 and grade IV 2. Of the 66 squamous cell carcinomas, six lesions co-existing with verrucous carcinoma were derived from the latter. This fact demonstrated that anaplastic transformation of verrucous carcinoma could occur in patients without radiotherapy. This study suggests that the enlarged neck lymph nodes need not be dissected prophylactically for patients with squamous cell carcinoma grade I and grade II, and with verrucous carcinoma. The management of the cervical nodes still suffices if they enlarge after the primary lesion has been removed. But radical dissection of neck lymph nodes should be performed promptly for patients with squamous cell carcinoma grade III and grade IV.     

High-resolution DNA flow cytometry in oral verrucous carcinoma

The classification of verrucous carcinoma as an entity unto itself or as a variant of well differentiated squamous cell carcinoma is controversial. To contribute new insights into the biological behavior of this rare tumor, we applied DNA flow cytometry to three node-negative verrucous carcinomas of the oral cavity. All tumors expressed a single aneuploid cell population. One of the patients experienced three courses with local recurrence. All secondary tumors retained the initially established aneuploid clone. The development of aneuploidy is thus a cytogenetic event common to both verrucous and squamous carcinoma of the oral cavity.     

Verrucous carcinoma of the maxillary antrum

Verrucous carcinoma is a well-differentiated variant of squumous cell carcinoma. In this article, we present a patient of verrucous carcinoma of the maxillary annum. There are only 6 reported cases of verrucous carcinoma of the maxillary antrum. Ours is the 7th case. We, here, would like to highlight that our case had a different clinical presentation from the previously reported cases.     

外阴鳞状细胞癌109例临床分析

目的 分析外阴鳞状细胞癌（简称：鳞癌）的临床资料,探讨外阴鳞癌发病的相关因素.法 回顾性分析109例外阴鳞癌患者的临床资料.结果 外阴鳞癌发病年龄多在50 ～ 69岁,病程多为6～12个月,好发于大阴唇,病灶大小2～4cm,90％以上为高分化鳞癌.按2009年外阴癌FIGO新分期重新划分结果,ⅠB期增多,Ⅱ、Ⅲ期下降.109例患者合并外阴上皮内非瘤样病变99例,白变主要累及大小阴唇,病理类型中外阴硬化性苔藓占60％（59/99）.多在病变的10～15年出现癌变.结论 外阴上皮内非瘤样病变与外阴鳞癌关系密切.长时间的病变有发生癌变的风险,定期复查可及早发现癌变.     

Primary intraosseous verrucous carcinoma developing from a maxillary odontogenic cyst: case report

Primary intraosseous carcinoma (PIOC) is an extremely rare lesion, almost always occurring in cranial bones. The origin of this tumor, specific to the maxillae, is associated with the cells of the epithelial rests of Malassez. Among the histotypes which can be included in these neoplasms, verrucous carcinoma is of particular interest due to its rarity: only a single case has been reported to date. After a short survey of the literature, the authors describe a directly observed case of verrucous carcinoma arising from a maxillary odontogenic cyst.     

Verrucous Bowen's disease of the plantar foot

A patient is presented with a recurrent plantar tumor present for 15 years. This hyperkeratotic exophytic tumor behaved historically and appeared clinically to be a verrucous carcinoma. Biopsy revealed Bowen's disease. The tumor was successfully treated with Mohs surgery. The tumor is presented due to its unusual location and its appearance that closely resembled verrucous carcinoma. The Mohs technique allows for total tumor ablation with maximal preservation of tissue in this important functional area.     

A case of verrucous carcinoma showing a good partial response by C.P.E. (CDDP, PEP, etoposide) chemotherapy]

A 60-year-old woman was admitted to our hospital with a complaint of rough feeling on the oral mucosa and diagnosed as verrucous carcinoma with histopathological examination. She was treated with CPE chemotherapy, and showed a good response and improvement of clinical symptoms. Toxicities were leukopenia, alopecia and anorexia. However, these were slight side effects. The patient is currently healthy with no recurrence after two years and 3 months. CPE chemotherapy is considered to be effective for a patient with verrucous carcinoma.     

外阴疣状癌3例并文献复习

目的：探讨外阴疣状癌的发病因素、临床表现、诊断及治疗。方法：回顾分析我院自1989年至今共收治3例外阴疣状癌的临床资料,并结合文献进行探讨。结果：3例疣状外阴癌均为老年,均来自经济落后、卫生条件较差的地区,且早婚、早育、多产,3例都通过2次以上活检确诊。其中2例手术治疗效果较好,术后才确诊为外阴疣状癌,1例第二次活检确诊为外阴疣状癌,放弃治疗死亡。结论：外阴疣状癌临床过程长,远处转移较少,预后较好,临床可疑病例应尽早活检,临床检查与病理结果不相符时建议活检组织要够深,防止误诊。必要时可多次活检以免漏诊。     

Squamous papilloma of the urinary tract is unrelated to condyloma acuminata

BACKGROUND: To the authors' knowledge, there is no previous report of squamous papilloma of the urinary tract. It is uncertain whether there is a correlation between squamous papilloma, condyloma acuminatum, and verrucous carcinoma. METHODS: The authors evaluated the clinical and pathologic features of squamous papilloma (5 of the bladder, 2 of the urethra), condyloma acuminatum (3 cases), and verrucous carcinoma (3 cases) of the urinary bladder and performed human papillomavirus (HPV) DNA in situ hybridization studies to determine whether HPV was a common feature shared by these lesions. In addition, DNA ploidy evaluation by image cytometry and p53 immunohistochemical staining were performed. RESULTS: Squamous papilloma of the urinary tract occurred in elderly women and followed a benign clinical course with infrequent recurrence. All squamous papillomas were HPV DNA negative and DNA diploid with no or minimal p53 nuclear accumulation. Condyloma acuminata of the bladder contained HPV DNA, increased p53 protein expression, and aneuploid DNA content. All three cases of condyloma acuminata were associated with coexistent condylomata of the external genitalia, and two required pelvic exenteration for uncontrolled expansile growth. Verrucous carcinoma of the bladder occurred in elderly patients. All three cases of verrucous carcinoma were negative for HPV DNA and DNA aneuploid, and they exhibited consistent p53 expression. CONCLUSIONS: These data indicate that squamous papilloma is a distinct entity not related to condyloma or verrucous carcinoma. These lesions are benign, HPV DNA negative, DNA diploid, and they lack p53 overaccumulation.     

CLINICOPATHOLOGICAL AND SURGICAL STUDY OF VERRUCOUS CARCINOMA OF PENIS

ＣＬＩＮＩＣＯＰＡＴＨＯＬＯＧＩＣＡＬＡＮＤＳＵＲＧＩＣＡＬＳＴＵＤＹＯＦＶＥＲＲＵＣＯＵＳＣＡＲＣＩＮＯＭＡＯＦＰＥＮＩＳＷａｎｇＸｕｚｈｏｕ；ＺｈａｎｇＺｉｘｕａｎ；ＧａｏＺｈｏｎｇｙｕ；ＬｉａｎｓＳｉｔａｉ；ＴｉａｎＪｉｘｉ王绪洲，张紫萱，高促...     

High intensity focused ultrasound treatment for non-neoplastic epithelial disorders of the vulva: Factors affecting effectiveness and recurrence

Abstract

Objective: This paper investigates the effectiveness of high-intensity focused ultrasound (HIFU) for treating non-neoplastic epithelial disorders of the vulva (NNEDV) and to analyse the factors that affect the effectiveness of HIFU and recurrence. Methods: This study included a total of 950 patients with pathologically confirmed NNEDV, who underwent HIFU treatment in our hospital between August 2008 and June 2013 and had completed follow-up data. Treatment efficacy and recurrence were evaluated retrospectively by analysing the patients’ clinical pathological data and by following up their symptomatic changes. We also explored factors including age, status of menopause, HPV infection, lesion size, pathological type, and symptom severity for their correlation with treatment effectiveness and recurrence. Results: HIFU was effective in alleviating symptoms and improving vulva signs, with a cure rate of 42.2%, an effective rate of 56.1%, and a low recurrence rate of 9.4%. No severe complications were recorded during or after the treatment. The treatment was statistically more effective in younger patients with squamous hyperplasia and smaller lesions than in older patients with lichen sclerosus and larger lesions (P?<?0.05). Patients with a longer disease course or with lichen sclerosus had significantly higher recurrence rates than those with a shorter disease course or with squamous hyperplasia (P?<?0.05). Conclusions: HIFU is safe and effective in treating NNEDV. Its effectiveness is correlated with age, size of lesion and pathological type, whereas post-treatment recurrence rates may be related to the duration of the disease and the pathological sub-types.