Photodynamic therapy in the treatment of the right buccal mucosa verrucous carcinoma: a case report and literature review / 口腔疾病防治

Objective@#To explore the photodynamic treatment method and therapeutic effect of oral verrucous carcinoma and to provide a reference for the clinic.@*Methods@#This study follows the requirements of medical ethics. This paper summarized the photodynamic treatment of an oral verrucous carcinoma with a diameter of approximately 2.5 cm in the right buccal mucosa and retrospectively analyzed the characteristics and treatment of oral verrucous carcinoma and the photodynamic treatment of potential malignant lesions of the oral mucosa through a review of the literature.@*Results@#After four rounds of photodynamic therapy, the size of the right buccal lesion was significantly reduced. After 6 months of follow-up, the white verrucous hyperplasia of the right buccal mucosa had completely subsided, and there was no obvious scar formation. Three years after treatment, there was no recurrence of the lesion in the right buccal mucosa and no obvious scar formation in the treated area. The degree of mouth opening was 3 fingers, and there was no lymph node enlargement in the bilateral submandibular, submental or neck. The literature review shows that oral verrucous carcinoma is a rare subtype of squamous cell carcinoma with the characteristics and biological behaviors of slow growth, low malignancy, and rare metastasis. Surgery is the preferred treatment, but there are some limitations. Photodynamic therapy is a minimally invasive, repeatable treatment with mild adverse reactions. In recent years, photodynamic therapy has been gradually applied for the treatment of potential malignant disorders of the oral mucosa and early oral squamous cell carcinoma and has achieved positive results, but it has not been reported for the treatment of oral verrucous cancer@*Conclusion@#Photodynamic therapy is a new option for nonsurgical resection of oral verrucous carcinoma.

Contiguous squamous proliferations in syringocystadenoma papilliferum: A retrospective study of 14 cases

Background: Syringocystadenoma papilliferum is a benign adnexal neoplasm. Contiguous squamous proliferation has been rarely described in syringocystadenoma papilliferum. Aims: This study aimed to evaluate the spectrum and pathogenesis of contiguous squamous proliferation in syringocystadenoma papilliferum. Materials and Methods: All cases of syringocystadenoma papilliferum diagnosed over the past 12 years were screened for contiguous squamous proliferation. Cases with associated nevus sebaceous were excluded from the study. Immunohistochemistry for GATA3, CK7, BRAFV600E and p16 was performed. PCR for human papilloma virus, type 16 and 18, was carried out. Results: Of a total of 30 cases, 14 cases showed associated contiguous squamous proliferation which included four cases of verrucous hyperplasia, six cases with papillomatosis, two cases with mild squamous hyperplasia and one case each of Bowen’s disease and squamous cell carcinoma. In the cases with non-neoplastic contiguous squamous proliferations, the squamous component did not express CK7 or GATA3. However, the squamous component of premalignant and malignant lesions expressed CK7 and GATA3 concordant with the adenomatous component. BRAF was positive in adenomatous component in five cases while the contiguous squamous proliferation component was negative for BRAF in all but one case. p16 was negative in both components of all cases and PCR for human papilloma virus was negative in all cases. Limitations: Due to the rarity of disease, the sample size of our study was relatively small with two cases in the 2nd group, that is, syringocystadenoma papilliferum with malignant contiguous squamous proliferation. Detailed molecular studies such as gene sequencing were not performed. Conclusion: Syringocystadenoma papilliferum with contiguous squamous proliferation is underreported, and most commonly displays verrucous hyperplasia. The premalignant and malignant contiguous squamous proliferations likely arise from syringocystadenoma papilliferum while the hyperplastic contiguous squamous proliferations likely arise from the adjacent epidermis. Relationship with high-risk human papilloma virus is unlikely. However, further molecular analysis of larger number of cases is required to establish the pathogenesis.

Oral Verrucous Hyperplasia with Dysplasia – A Case Report

Introduction: Verrucous Papillary Lesions (VPLs) clinically present themselves as an exophytic growth seen commonly as grey- white in color. A dominant part of the favorable VPLs have viral etiology and incorporate commonly occurring squamous papil- loma alongside verruca vulgaris, central epithelial hyperplasia, and condyloma. Current comprehension of possibly malignant VPLs is astounding and is basically ascribed to the utilization of confounding and unacceptable terminology. Verrucous Hyper- plasia (VH) of the oral mucosa is a relatively intricate entity possessing paradoxical features making it difficult to diagnose when compared to other verruco-papillary lesions such as Verrucous Carcinoma (VC). Case Presentation: This case report depicts the presentation of Oral verrucous hyperplasia along with dysplasia seen in buccal mucosa of a 46-year-old patient. Management and Prognosis: Surgical excision was performed and ensured that margins were included in the excision to avoid any recurrence of the lesion. Conclusion: The most dependable approach to isolate these substances on routine hematoxylin-eosin stained tissue areas is to perceive the exophytic growth patterns of oral verrucous hyperplasia from the combined exophytic and endophytic growth patterns related with verrucous carcinoma. Furthermore, investigations on this are required using Immunohistochemical meth- ods.

Verrucous carcinoma in association with oral submucous fibrosis.

Oral verrucous carcinoma is a form of well differentiated squamous cell carcinoma characterized by exophytic over growth. It is slow growing and locally invasive tumor occurring in 6 th and 7 th decade of life. Smoking and chewing tobacco is found to be the most common etiological factor of verrucous carcinoma although oral leukoplakia may act as a predisposing factor. This is a rare case of oral varrucous Carcinoma seen in association with oral submucous fibrosis in a younger patient with long standing history of chewing tobacco.

A Case of Verrucous Hyperplasia at the Site of Healed Herpes Zoster: Isotopic Response / 대한피부과학회지

An isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, or already healed skin disease. The most common course of an isotopic response is a herpes zoster disease. Verrucous hyperplasia is known as a reactive hyperplastic condition, characterized morphologically by numerous, warty, coalescent papules and plaques. We report here on a case of verrucous hyperplasia developed at the site of healed herpes zoster, which is an unusual type of isotopic response.

A Case of Verrucous Hyperplasia with Lymphedema of Leg Amputation Stump / 대한피부과학회지

Verrucous hyperplasia appears as multiple, warty, coalescent papules arising on the distal portion of amputation stump skin, yet it displays no histological evidence of viral warts. It occurs when the chronic pressure of a poor prosthetic fit disrupts vascular and lymphatic channels, subsequently causing chronic tissue edema. We report a case of 30 year old male, with 15 year history of wearing below-the-knee prosthesis, who presented with a verrucous papule that arose at his amputation site. Histopathological findings showed hyperkeratosis, acanthosis, superficial dermal edema and dilated thick vessles oriented vertical to the skin surface. Verrucous hyperplasia with lymphedema was diagnosed on the basis of clinical and histological findings.

A Case of Verrucous Hyperplasia with Lymphedema at the Distal Stump of a Below-the-knee Amputee / 대한피부과학회지

Verrucous hyperplasia of the distal stump skin is a rare condition which shows multiple, irregular warty papules and plaques but histologically no evidence of viral warts. It has been suggested that verrucous hyperplasia results from persistent stump edema, usually when the distal stump is unsupported in the prosthesis socket. We present a 53-year-old male who showed verrucous plaques on the distal stump skin and also showed edematous change with oozing. He has been wearing a below-the-knee prosthesis for 35 years since a traumatic amputation and has not changed the prosthesis for 30 years. Histopathological findings showed hyperkeratosis, parakeratosis, acanthosis, papillomatosis, dermal edema, fibrosis, dermal vessel proliferation and dilatation. He was diagnosed as having verrucous hyperplasia with lymphedema by clinical and histopathological findings.

A Case of Verrucous Hyperplasia with Lymphedema of the Leg Amputation Stump / 대한피부과학회지

Verrucous hyperplasia shows multiple warty like lesion on the amputation stump, but the pathologic findings of viral verrucae has not been discovered. A verrucous plaque on the amputation stump of the right leg was found in 31-year-old man. He had suffered from a traumatic amputation of right leg since 8 years ago. A leg prosthesis had been worn since that time. Histopathologic findings shows hyperkeratosis, acanthosis, papillomatosis, superficial dermal edema and dilated thick-walled venules oriented vertical to the skin surface. Verrucous hyperplasia was diagnosed with lymphedema on the basis of clinical and histological findings.

A Case of Verrucous Hyperplasia in An Amputee / 대한피부과학회지

Chronic dermatological problems associated with lower limb amputation sites include local maceration, intertrigo, blistering and ulceration, contact dermatitis, tissue atrophy, verrucous hyperplasia, lichenification, callosities, epidermoid cyst formation, and malignant neoplasia. A 60 year-old male was presented with a verrucous oozing eruption of the amputation stump of the left leg. He had been involved in a railroad logging accident 30 years before, resulting in the loss of the left lower limb. He were a below-knee prosthesis (patellar-tendon hearing). We diagnosed him as verrucous hyperplasia by clinical and histological findings and then referred him to the division of rehabilitation for a refitting of his prosthesis, after which his eruption cleared two months later.