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.

ANGIOKERATOMA: A RARE MANIFESTATION

Angiokeratoma shows dilatation of capillaries in the upper dermis and it also shows some epidermal changes, like- hyperkeratosis, papillomatosis, and thickening of epidermis or acanthosis .Clinical presentation of angiokeratoma includes plaques over the skin of lower limbs, mostly on the buttocks or thigh. It is usually identified clinically but a definitive diagnosis is made only on histopathological examination.A deeper biopsy of the lesion is empirically essential to make a concrete diagnosis as the characteristic changes seen in angiokeratoma, are limited to superficial dermis. Our case report has a 24 years old female presenting with unilateral, linear, bluish-black verrucous plaque on the back of left elbow.

Carcinoma escamoso híbrido de la planta del pie / Squamous hybrid carcinoma of the sole of the foot

Resumen El carcinoma escamoso (CEC) es un tumor maligno de la epidermis y sus anexos. Es el segundo en frecuencia después del carcinoma basocelular y presenta distintas variantes clinicopatológicas. El subtipo carcinoma verrucoso (CV) es una variante poco frecuente de CEC con características histopatológicas y comportamiento específico. Ocasionalmente, se pueden observar componentes carcinomatosos de células escamosas convencionales en el CV, denominándose a esta entidad tumores "híbridos", los cuales representan el 20% de los casos observados. Reportamos el caso de un paciente varón de 72 años con una gran lesión exofítica que compromete 5to dedo y planta de pie derecho con diagnóstico de carcinoma escamoso híbrido. El objetivo de la presentación es mostrar una asociación infrecuente, haciendo énfasis en su seguimiento cercano ya que puede manifestar cambios en su comportamiento clínico diseminándose a los ganglios linfáticos regionales.

Abstract Squamous carcinoma (SCC) is a malignant tumor of the epidermis and its appendages. It is the second most common after basal cell carcinoma and has different clinicopathological variants. The verrucous carcinoma (VC) subtype is a rare variant of SCC with histopathological characteristics and specific behavior. Occasionally, carcinomatous components of conventional squamous cells can be observed in the VC, this entity being called "hybridized" tumors, which represent 20% of cases.We report the case of a 72-year-old male with a large exophytic lesion involving the 5th right toe and foot with a diagnosis of squamous hybrid carcinoma. The objective of the presentation is to show an infrequent association, emphasizing its close follow-up as it can modify its clinical behavior by spreading to regional lymphnodes.

Definitive Radiotherapy versus Surgery for the Treatment of Verrucous Carcinoma of the Larynx: A National Cancer Database Study

Abstract Introduction Traditionally, larger lesions of laryngeal verrucous carcinoma are treated with surgical excision, with definitive radiotherapy generally reserved for smaller lesions. However, data utilizing modern databases is limited. Objective The authors sought to assess, utilizing the National Cancer Database, whether overall survival for patients with laryngeal verrucous carcinoma was equivalent when treated with definitive radiotherapy versus definitive surgery. Methods A retrospective cohort study was conducted utilizing the National Cancer Database. All cases of laryngeal verrucous carcinoma within the National Cancer Database between 2006 and 2014 were reviewed. Patients with T1-T3 (American Joint Commission on Cancer 7th Edition) laryngeal verrucous carcinoma were included and stratified by treatment modality. Demographics, treatment, and survival data were analyzed. Results A total of 392 patients were included. Two hundred and fifty patients underwent surgery and 142 received radiotherapy. The two groups differed in age, transition of care, clinical T stage, and clinical stages. There was no significant difference in survival between T1-T3 lesions treated with surgery or radiotherapy (p =0.32). Age, comorbidities, insurance status, and clinical T stage impacted overall hazard on multivariate analysis (p <0.01). For patients treated with radiotherapy, age, insurance status, and clinical T stage were predictive of increased hazard. Conclusion Overall survival is equivalent for patients with clinical T1 and clinical T2 laryngeal verrucous carcinoma treated with primary radiotherapy versus primary surgery. Thus, radiotherapy should be considered as a non-inferior treatment modality for certain patients with laryngeal verrucous carcinoma.

Carcinoma verrucoso, una variante inusual de tumor laríngeo / Verrucous carcinoma, an unusual variant of laryngeal tumor

Introducción: El carcinoma verrucoso es una variante poco común de carcinoma escamoso bien diferenciado, que carece de rasgos citológicos de malignidad, tiene un crecimiento lento, es infiltrativo, pero no metastatiza. Objetivo: Identificar los aspectos clínico-histopatológicos y terapéuticos de una variante inusual de tumor laríngeo. Presentación del caso: Se reporta un nuevo caso de carcinoma verrucoso, paciente masculino de 78 años que se presentó en la consulta de Otorrinolaringología del Hospital Docente general "Enrique Cabrera" con disfonía. Se realizó laringoscopia indirecta y se detectó lesión exofítica sugestiva de neoplasia. Se tomaron tres biopsias, solo la última, fue de utilidad para diagnosticar un carcinoma verrucoso. Se trató con radiaciones y cirugía. El paciente presenta un intervalo libre de enfermedad después de ocho años de seguimiento. Conclusiones: Para el diagnóstico del carcinoma verrucoso es necesario biopsias profundas y la acuciosidad del patólogo para llegar al diagnóstico. Se hace énfasis en la importancia del trabajo en el contexto del grupo multidisciplinario(AU)

Introduction: Verrucous carcinoma is an uncommon variant of a well differentiated squamous carcinoma that lacks cytological features of malignancy and is often slow-growing, infiltrative, but not metastatic. Objective: To identify the clinical, histopathologic and therapeutic aspects of an unusual variant of laryngeal tumor. Case presentation: A 78-year-old male patient who attended the otorhinolaryngology consultation at "Enrique Cabrera" General Teaching Hospital with dysphonia is reported as a new case of Verrucous carcinoma. Indirect laryngoscopy was performed and an exophytic lesion suggestive of neoplasia was detected. Three biopsies were taken, but only the last one was useful to diagnose a Verrucous carcinoma. It was treated with radiation and surgery. The patient has a disease-free survival after eight years of follow-up. Conclusions: Deep biopsies performed by a skillful pathologist are necessary to reach the diagnosis of Verrucous carcinoma. Emphasis is placed on the importance of working in the context of a multidisciplinary team(AU)

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.

Hybrid Verrucous Carcinoma: A Wolf in Sheep's Clothing Case Report and Integrative Review of 280 Cases

ABSTRACT: Hybrid verrucous carcinoma (HVC) is defined as a rare neoplasm in which there is histopathological evidence of verrucous carcinoma and microscopic foci of squamous cell carcinoma, synchronously in the same site, affecting behavior and prognosis. This study aimed to present a new case of HVC in the mouth, and critically and comparatively analyze the cases reported in literature, to better understand the biological behavior and contribute to diagnostic precision. A review was performed using six databases, and the gray literature. Twenty-two articles were selected, with a total of 280 cases. The most frequent clinical appearance was verrucous carcinoma which included benign lesions. This implies that the potential for aggressive behavior can be detected microscopically, in the form of a ruptured basement membrane, which visualization can be facilitated by the use of some immunohistochemical markers discussed here. This is important for the diagnosis of HVC and adequate treatment. Hybrid verrucous carcinoma is what can be thought of as "a wolf in sheep's clothing." When analyzing cases with clinical suspicion of verrucous carcinoma microscopically, great attention is recommended, since they may be HVC and can recur, metastasize, and lead to death.

RESUMEN: El carcinoma verrugoso híbrido (CVH) se define como una neoplasia poco frecuente en la que existe evidencia histopatológica de carcinoma verrugoso y focos microscópicos de carcinoma de células escamosas, sincrónicamente en el mismo sitio, que afectan el comportamiento y el pronóstico. Este estudio tuvo como objetivo presentar un nuevo caso de CVH en la cavidad oral, y analizar crítica y comparativamente los casos reportados en la literatura, para comprender mejor el comportamiento biológico y contribuir a la precisión diagnóstica. Se realizó una revisión utilizando seis bases de datos y la literatura gris. Se seleccionaron veintidós artículos, con un total de 280 casos. La aparición clínica más frecuente fue el carcinoma verrugoso que incluyó lesiones benignas. Esto implica que el potencial de comportamiento agresivo puede detectarse microscópicamente, en forma de una membrana basal rota, cuya visualización puede ser facilitada por el uso de algunos marcadores inmunohistoquímicos discutidos aquí. Esto es importante para el diagnóstico de CVH y el tratamiento adecuado. El CVH es lo que se puede considerar como "un lobo con piel de oveja". Al analizar microscópicamente casos con sospecha clínica de carcinoma verrugoso, se recomienda una atención inmediata debido a que pueden ser CVH y pueden recurrir, metastatizar y conducir a la muerte.

Lesiones tumorales en región oral: carcinoma verrucoso y carcinoma oral de células escamosas. Reporte de un caso / Tumor lesions in the oral region: verrucous carcinoma and oral squamous cell carcinoma. A case report

El carcinoma oral de células escamosas representa un problema en la salud pública a nivel mundial. Siendo la neoplasia maligna más frecuente en la cavidad oral y uno de los diez cánceres más comunes en todo el mundo. El carcinoma verrucoso es una variante del carcinoma oral de células escamosas que presenta un alto grado de invasión local y baja posibilidad de extenderse. Además, representa del 2 al 12% de todos los carcinomas orales, con una tasa de supervivencia de 5 años. El presente artículo reporta el caso de un paciente masculino de 79 años, después de realizados los exámenes extra e intraoral, así como los complementarios, se observa un aumento de volumen en la porción anterior de la mandíbula, crateriforme irregular, doloroso a la palpación. Se diagnosticó carcinoma verrucoso involucrando a los órganos dentarios 3.3-4.3 y la mucosa circundante. El tratamiento consistió en la remoción quirúrgica completa, sin alteración o daño a las zonas circundantes, con seguimiento postoperatorio. El conocimiento de este tipo de patología puede orientar al odontólogo a la sospecha de diferentes lesiones cancerígenas, lo que permitirá prevenir complicaciones y así brindar la mejor opción de tratamiento a los pacientes afectados.

Oral squamous cell carcinoma represents a worldwide public health problem. Being the most common malignant neoplasm in the oral cavity and one of the ten most common cancers worldwide. Verrucous carcinoma is a variant of oral squamous cell carcinoma that has a high degree of local invasion and low possibility of spreading. In addition, it represents 2 to 12% of all oral carcinomas, with a 5-year survival rate. This article reports the case of a 79-year-old male patient, after performing the extra and intraoral exams, as well as the complementary ones, an increase in volume is observed in the anterior portion of the mandible, irregular crateriform, painful on palpation. Verrucous carcinoma was diagnosed involving teeth 3.3-4.3 and the surrounding mucosa in the oral cavity. The treatment consisted of complete surgical removal, without alteration or damage to the surrounding areas, with postoperative follow-up. Knowledge of this type of pathology can guide the dentist to the suspicion of different cancerous lesions, which will prevent complications and thus provide the best treatment option for affected patients.

Carcinoma Cuniculatum Masquerading as Wart

@#Carcinoma cuniculatum is a rare, slow growing tumour which is commonly mistaken for warts or corn especially when it presents on the sole. Although it rarely metastasizes, it may cause local invasion affecting the underlying tissue and bone. Early identification provides good prognosis as it can be managed with localized resection. We present a case of carcinoma cuniculatum which was misdiagnosed and treated as a common wart for two years until the diagnosis was confirmed by histopathology. By the time of diagnosis, the lesion had involved the underlying bone and patient required amputation. Carcinoma cuniculatum is rare and easily confused with common warts in the early stages hence, it is important to create awareness to identify and differentiate these two conditions.

Carcinoma de células escamosas de la lengua / Squamous cell carcinoma of the tongue

Las neoplasias de la lengua son los tumores más comunes de la cavidad bucal y la mayoría pertenecen a carcinomas de células escamosas. Presentamos dos casos de carcinomas de la lengua, correspondientes a un carcinoma escamoso moderadamente diferenciado y un carcinoma verrugoso, en mujeres de mediana edad con factores de riesgo oncogénicos. Estos tumores pueden tener diversos grados de diferenciación, los cuales determinan su pronóstico y tratamiento.

Tongue neoplasms are the most common in the oral cavity, and the majority correspond to squamous cell carcinomas. We present two cases of tongue carcinomas, corresponding to moderately differentiated squamous cell carcinoma and verrucous carcinoma, in middle-aged women with oncogenic risk factors.These tumors can have various degrees of differentiation, which determine their prognosis and treatment.

Evaluation of squamous cell carcinoma antigen 1 expression in oral squamous cell carcinoma (tumor cells and peritumoral T-lymphocytes) and verrucous carcinoma and comparison with normal oral mucosa

Abstract Background: Squamous cell carcinoma antigen (SCCA) is used as a prognostic marker for recurrence of squamous cell carcinoma in various sites, including head and neck. Studies suggest that its high serum levels are correlated to some clinical features, such as nodal metastasis. However, it is still unknown if high SCCA in patients with SCCA tissue expression in tumor cells are related to peripheral T-lymphocytes. Therefore, we did this study to evaluate SCCA expression in squamous cell carcinoma and verrucous carcinoma and to compare it with normal oral mucosa, also investigating the correlation between serum-based and tissue-based antigen levels. Methodology: In this study, the immunohistochemistry (IHC) technique was used to determine the SCCA1 expression pattern in 81 specimens divided into 3 groups, including oral squamous cell carcinoma, verrucous carcinoma, and normal oral mucosa. Serum-based and tissue-based antigen levels of 20 oral squamous cell carcinoma cases were compared by the western blot assay. SCCA expression was also evaluated and compared in both tumor cells and peripheral T-lymphocytes by the immunofluorescence assay. Results: Our results showed that the SCCA levels in SCC specimens were significantly lower than in verrucous carcinoma and normal and hyperplastic oral mucosa specimens. We found no correlation between the IHC expression of SCCA and serum levels. SCCA was well expressed in both tumor cells and peripheral T-lymphocytes. Conclusion: Decreasing SCCA in SCC specimens suggested that SCC tumor cells may affect more than the serum levels of SCCA in some patients. In addition, expression of SCCA in peripheral T-lymphocytes showed that both tumor cells and T-lymphocytes may cause serum SCCA.

Squamous cell carcinoma with sarcomatous transformation of the penis

Malignant tumors of the penis are rare, most of them being squamous cell carcinomas (SCCs). We report the case of a 75-year-old man with a large penile mass submitted to partial penectomy. The specimen showed an exophytic mass involving the glans, coronal sulcus, and prepuce. Microscopic examination showed a carcinoma with two distinct areas: a mixed SCC and a sarcomatoid carcinoma. The SCC component had areas of verrucous carcinoma and areas of classical invasive SCC. The tumor cells expressed p63 with the absence of p16 expression. Vimentin and p53 were positive in the sarcomatous component. The morphology and immunohistochemistry were compatible with mixed SCC (verrucous hybrid-sarcomatoid carcinoma). Additionally, the tumor cells also expressed 3 different clones of PDL1 (22C3, SP263, and SP142). Two months later, the patient presented local recurrence with multiple lymph nodes and lung metastases, dying 7 weeks later. Mixed tumors represent diagnostic challenges. The correct identification of adverse prognostic factors can be the first step to implement the treatment with a higher probability of success.

Tumor de Buschke-Löwenstein: presentación de un caso / Buschke-Lowenstein tumor: presentation of the case

RESUMEN Fundamento: el tumor de Buschke-Löwenstein es un condiloma acuminado gigante mayor de 10 cm más frecuente en hombres, por lo que el tratamiento de elección debe ser siempre quirúrgico. Objetivo: describir un caso de condiloma acuminado gigante. Presentación del caso: paciente masculino blanco de 54 años de edad, que acudió a consulta con formaciones papilomatosis con aspecto de coliflor de consistencia blanda y húmedas, en ambas regiones inguinales; del lado derecho de 13 cm de diámetro y de 19 cm la izquierda y en la raíz del pene y región perianal de 2 cm, asociadas a dolor de ligera intensidad en miembros inferiores y fetidez ocasional. Se le realizaron estudios preoperatorios incluidos serología y VIH no reactivos. Se operó, realizándole exéresis y cierre con colgajo cutáneo abdominal. Evolucionó estable clínicamente, aunque presentó una infección de la herida quirúrgica donde se reportó Escherichia coli, sensible a gentamicina; cumplió con el tratamiento y egresó sin complicaciones posteriores. Conclusiones: el tumor de Buschke-Löwenstein se considera en la actualidad como una forma de carcinoma verrucoso, no presenta atipias celulares, descrito como benigno, pero un tercio de los casos puede malignizar. No obstante, por las frecuentes recidivas, es considerado por algunos autores como un tumor maligno. A pesar de existir varios tratamientos, es el quirúrgico el de mejores resultados.

ABSTRACT Background: the Buschke-Löwenstein tumor is a giant acuminate condyloma larger than 10 cm, more frequent in men, so the treatment of choice must always be surgical. Objective: to describe a case of giant acuminate condylomata. Case report: 54-year-old white male patient, who came with papillomatosis formations with soft and moist consistency of cauliflower, in both inguinal regions; on the right side of 13 centimeters in diameter and 19 centimeters on the left and at the root of the penis and perianal region of 2 centimeters, associated with pain of slight intensity in the lower limbs and occasional fetidity. Preoperative studies including non-reactive serology and HIV were performed. He underwent surgery, performing excision and closure with abdominal skin flap. He evolved clinically stable, although he presented an infection of the surgical wound where Escherichia Coli, gentamicin sensitive, was reported; he complied with treatment and left without further complications. Conclusions: Buschke-Löwenstein tumor is currently considered as a form of verrucous carcinoma, it does not present cellular atypia, described as benign, but one third of the cases can be maligne. Despite frequent recurrences, some authors consider it as a malignant tumor. Despite the existence of several treatments, the surgical treatment is the one with the best results.

Presentación inusual de epitelioma curriculatum en escolar de 12 años / Unusual presentation of curriculatum epitelioma in a 12 years old schoolchild

Introducción: El carcinoma verrugoso es una variante inusual bien diferenciada del carcinoma epidermoide que tiende a aparecer en adultos de mediana edad o mayores. Se considera una neoplasia maligna de grado bajo con cuatro subtipos principales. Objetivo: Referir la infrecuente presentación del carcinoma verrugoso en un adolescente. Presentación de caso: Escolar masculino de 12 años de edad, de raza mestiza, que acude a Consulta Especializada de Dermatología en el Hospital Clínico Quirúrgico Docente Celia Sánchez Manduley con lesión vegetante localizada en planta de pie derecho; se realizan complementarios, biopsia excisional más injerto y se concluye el caso como epitelioma curriculatum. Conclusiones: A nivel clínico, los carcinomas verrugosos se presentan en forma de tumores exofíticos con una superficie papilomatosa o verrugosa. Se asocian con frecuencia a la infección por el virus del papiloma humano, y puede ser difícil distinguir entre un carcinoma verrugoso y una verruga. Es importante el reconocimiento temprano para guiar un diagnóstico preciso y tratamiento oportuno(AU)

Introduction: Verrucous carcinoma is a well differentiated unusual variant of squamous cell carcinoma that tends to occur in middle-aged or older adults. It is considered a low-grade malignant tumour with four main subtypes. Objective: To explain the uncommon presentation of the verrucous carcinoma in a teenager and the importance of early recognition to guide an accurate diagnosis and a timely treatment. Case presentation: 12 years old, school age male, mixed race who attends to specialized consultation of Dermatology in Celia Sánchez Manduley Surgical Clinical Hospital presenting a vegetating lesion located in the right foot´s sole; there were made complementary blood tests, an excisional biopsy plus graft and the case was finally diagnoses as curriculatum epithelioma. Conclusions: At the clinical level, the verrucous carcinomas are presented in the form of exophytic tumors with a papillomatous or verrucous surface. They are often associated with the human papilloma virus infection, and it may be difficult to distinguish between a verrucous carcinoma and a wart(AU)

Epitelioma cuniculatum asociado al virus papiloma humano. Presentación de caso / Epithelioma cuniculatum associated with human papillomavirus. Case presentation

Introducción: El epitelioma cuniculatum es una variante infrecuente del carcinoma epidermoide, es el subtipo cutáneo del carcinoma verrugoso, que afecta al pie y que puede estar relacionado con el virus papiloma humano (VPH). El hecho de que la lesión inicial sea a menudo confundida con una verruga plantar dilata su diagnóstico y tratamiento. Objetivo: reportar un caso poco frecuente de un paciente con carcinoma cuniculatum del pie derecho, relacionado con VPH, de larga evolución, que se extendió formando una masa vegetante, afectando los tres últimos dedos. Presentación del caso: se presentó un paciente masculino blanco (fototipo III) de 69 años de edad, que en tres ocasiones se le habían resecado verrugas plantares en el pie derecho, presentó una evolución tórpida con aparición de lesión ulcerosa de 2 centímetros de diámetro, con biopsia positiva a carcinoma epidermoide asociado a VPH, al cual se le realizó desarticulación con bordes de seguridad de la lesión. Conclusiones: Se presentó un raro caso de carcinoma epidermoide del pie, relacionado con una verruga plantar asociada a VPH, la cual inicialmente fue extirpada quirúrgicamente de forma inadecuada(AU)

Introduction: Epitelioma cuniculatum is an unusual variant of epidermoid carcinoma. It is the subtype of cutaneous verrucous carcinoma that affects the foot and can be associated with the human papillomavirus (HPV). The lesion is frequently confused with plantar warts, delaying its diagnosis and treatment. Objective: To present an uncommon case of a patient with long history of epitelioma cuniculatum of the right foot associated with HPV, which spread out forming a vegetative mass affecting the last three toes. Case presentation: A sixty-nine-year-old white male patient (phototype III) that in three different moments had undergone excision of plantar warts in the right foot presented a torpid evolution with the appearance of ulcerative lesion of two centimeters in diameter. The biopsy was positive to epidermoid carcinoma associated with HPV; so, resection including safety margins around the tumor was performed. Conclusion: An unusual case of epidermoid carcinoma of the foot related to a plantar wart associated with HPV, which was initially removed by inadequate surgery, is presented(AU)

Nevo epidérmico verrugoso inflamatorio lineal extenso. Reporte de un caso / Extensive linear inflammatory wart epidermal nevus. Case Report

Resumen El nevo epidérmico verrugoso inflamatorio lineal (NEVIL), es una variante rara de nevo epidérmico que aparece con mayor frecuencia al nacer o en la primera infancia. Clínicamente, se presenta como placas eritematosas, queratósicas muy pruriginosas siguiendo las líneas de Blaschko. La anatomía patológica cumple un rol esencial para el diagnóstico diferencial y el tratamiento constituye un desafío médico. Presentamos el caso de un paciente masculino de 38 años de edad, con manifestación extensa de la patología y poca respuesta al tratamiento.

Abstract Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare variant of epidermal nevus that appears most frequently at birth or in early childhood. Clinically, it is presented as pruritic keratotic erythematous plaques, following the lines of Blaschko. Histopatology plays an essential role for differential diagnosis and treatment constitutes a medical challenge. We present the case of a 38-year-old man, with extensive presentation of the pathology and little response to topical therapy.

Tumor de Buschke-Lowenstein perianal: relato de dois casos tratados com podofilina em vaselina sólida 25% / Perianal Buschke-Lowenstein tumor: report of two cases treated with 25% podophyllin ointment

O tumor de Buschke-Lowenstein (TBL) é variante extremamente rara do condiloma acuminado que, apesar de manifestar-se clinicamente por lesões de grandes proporções, apresenta comportamento biológico e características histológicas benignas. Existem diversas abordagens terapêuticas disponíveis, muitas delas apoiando-se em abordagens cirúrgicas extensas e mutilantes. Apresentamos dois casos de pacientes com TBL tratados com podofilina tópica, cujas respostas terapêuticas foram extremamente favoráveis em ambos os casos.

Buschke-Lowenstein tumor (BLT) is an extremely rare variant of condylomata acuminata that despite being clinically presented by large lesions, presents a benign biological behavior and histological characteristics. There are a number of therapeutic approaches available, many of which rely on extensive and mutilating surgical procedures. We present two cases of patients with BLT treated with topical podophyllin whose therapeutic responses were extremely favorable in both cases.

Nevus epidérmico verrucoso inflamatorio lineal: una revisión de la literatura / Inflammatory linear verrucous epidermal nevus: a review of the literature

El nevus epidérmico verrucoso inflamatorio lineal (NEVIL) es un tipo de nevus epidérmico queratinocítico, poco frecuente, de aparición predominante en la infancia, con preponderancia sobre el sexo femenino. Se caracteriza por la presencia de pápulas eritematosas descamativas de aspecto psoriasiforme, intensamente pruriginosas, que tienden a coalescer para formar placas que se distribuyen siguiendo las líneas de Blaschko. Suele presentarse de forma unilateral en extremidades inferiores y tiene pobre respuesta al tratamiento.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare type of keratinocytic epidermal nevus that predominantly appears in childhood and female sex. It is characterized by the presence of psoriasiform, scaly, intensely itchy erythematous papules that tend to coalesce to form plaques that are distributed along Blaschko's lines. It usually affects the lower extremities unilaterally, and responds poorly to treatment.

Carcinoma verrucoso en lengua de paciente geriátrica. Informe de caso clínico / Verrucous carcinoma in the tongue of a geriatric patient. Clinic case report

Resumen Se informa el caso de un paciente femenino de 80 años de edad, la cual presenta un crecimiento exofítico en el borde lateral izquierdo de la lengua con dolor a la masticación y deglución de alimentos y bebidas; es referida por el odontólogo del Hospital Primario del municipio de Villanueva, departamento de Chinandega, Nicaragua, al área de Diagnóstico en Patología Bucal de la Facultad de Odontología de la Universidad Nacional Autónoma de Nicaragua, León (UNAN-León). A la exploración clínica se observa lesión exofítica en la zona posterior del borde lateral izquierdo de la lengua de aspecto papilomatoso, y ocupa además el reborde alveolar del mismo lado. El diagnóstico definitivo histopatológico fue carcinoma verrucoso.

Abstract We report the case of an 80-year-old female patient, who presents an exophytic growth on the left lateral border of the tongue with pain when chewing and swallowing food and drinks; who is referred by the Dentist of the Primary Hospital of the municipality of Villanueva, department of Chinandega, Nicaragua to the area of Oral Pathology Diagnostics of the National Autonomous University of Nicaragua, Dental School León (UNAN-León). An exophytic lesion was observed in the posterior area of the left lateral border of the papillomatous aspect of the tongue, occupying in addition the alveolar ridge on the same side. The definitive histopathological diagnosis was Verrucous carcinoma.