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.

Downregulation of Notch4 - a prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma / Regulação descendente de Notch4 - um marcador prognóstico na distinção entre carcinoma verrucoso oral e carcinoma de células escamosas oral

Abstract Introduction: Oral verrucous carcinoma is a special form of well-differentiated squamous cell carcinoma which possesses specific clinical, morphologic and cytokinetic features that differ from other types of oral cancers and hence diagnosis requires immense experience in histopathology. Hence it is certainly important to distinguish such a lesion from other oral tumors as treatment strategies vary widely between them. Objective: In search of a critical diagnostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma, Notch4 receptor, one of the key regulatory molecules of the Notch signaling family has been aberrantly activated in the progression of several types of tumors. However its function in oral verrucous carcinoma remains unexplored. Thus the present study aims in determining the differential expression pattern of Notch4 in oral verrucous carcinoma and oral squamous cell carcinoma. Methods: Ten patients reported positive for oral cancer (5 patients with oral verrucous carcinoma and 5 patients with oral squamous cell carcinoma). Five normal tissue samples were also obtained and evaluated for clinicopathological parameters and immunohistochemistry, western blotting and real time polymerase chain reaction for Notch4 expression. Results: Our results reveal that the expression of Notch4 was considerably high in oral squamous cell carcinoma lesions compared to normal tissue, whereas in oral verrucous carcinoma, irrespective of the clinicopathological features, complete regulação descendente of Notch4 was observed. Conclusions: These preliminary findings strongly support the fact that Notch4 is downregulated in oral verrucous carcinoma and could be considered as a suitable prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma. This distinguishing marker can help in improving therapeutic options in patients diagnosed with oral verrucous carcinoma.

Resumo Introdução: O carcinoma verrucoso de cavidade oral é uma forma especial de carcinoma de células escamosas bem diferenciada que tem características clínicas, morfológicas e citocinéticas específicas que diferem de outros tipos de cânceres orais. Por essa razão, o diagnóstico requer grande experiência em histopatologia. Portanto, é certamente importante distingui-lo de outros tumores orais, pois as respectivas estratégias de tratamento variam muito. Objetivo: Em busca de um marcador de diagnóstico crítico na distinção entre o carcinoma verrucoso e o carcinoma de células escamosas de cavidade oral, o receptor Notch4, uma das principais moléculas reguladoras da família de sinalizadores Notch, foi ativado de maneira anormal na progressão de vários tipos de tumores. No entanto, sua função no carcinoma verrucoso permanece inexplorada. Assim, o presente estudo tem como objetivo determinar o padrão de expressão diferencial de Notch4 no carcinoma verrucoso e de células escamosas de cavidade oral. Método: Dez pacientes tiveram resultado positivo para câncer oral (cinco pacientes com carcinoma verrucoso e cinco pacientes com carcinoma de células escamosas) e cinco amostras normais foram também obtidas. Além da avaliação dos parâmetros clínico-patológicos, foram feitos análise imuno-histoquímica, Western Blot e reação de polimerase em cadeia em tempo real para a expressão de Notch4. Resultados: Nossos resultados revelam que a expressão de Notch4 foi consideravelmente alta em carcinomas de células escamosas em comparação com os tecidos normais, enquanto que no carcinoma verrucoso, independentemente das características clínico-patológicas, observou-se regulação descendente completa de Notch4. Conclusão: Esses achados preliminares apoiam fortemente o fato de que Notch4 estava regulado para baixo no carcinoma verrucoso oral e poderia ser considerado um marcador prognóstico adequado para distinguir entre carcinoma verrucoso e carcinoma de células escamosas de cavidade oral. Esse marcador distintivo pode ajudar a melhorar as opções terapêuticas em pacientes com diagnóstico de carcinoma verrucoso oral.

Comorbidity between HTLV-1-associated adult T-cell lymphoma/leukemia and verrucous carcinoma: a case report / Comorbilidad entre carcinoma verrugoso y linfoma/leucemia de células T del adulto asociado con HTLV-1: un reporte de caso

Abstract Background: Adult T-cell Leukemia/Lymphoma (ATLL) is classified as a peripheral CD4+ T-cell neoplasm caused by the human T-cell lymphotropic virus type 1 (HTLV-1). Typical symptoms are associated with leukemic infiltration; however, atypical and exaggerated manifestations of verrucous carcinoma have also been described. Case report: We present here the case of a patient with multiple skin lesions, ischemic necrosis in the hallux and lymphadenopathies. Biopsies were taken, which showed verrucous epidermal carcinoma and cutaneous lymphoma. Splenomegaly and adenopathy in mesentery, retro peritoneum and lymph node chains in the limbs were observed. Bone marrow examination showed findings compatible with T-cell leukemia/lymphoma; and it was ELISA positive for HTLV-1/2. Treatment and outcome: The patient had a good initial response to a CHOP scheme (cyclophosphamide, doxorubicin, vincristine and prednisone) with filgrastim. However, the patient had a relapse and died before the second cycle. Clinical relevance: Comorbidity could lead to the associated risk factors model. According to this model, secondary immunodeficiency caused by HTLV-1 may induce the development of verrucous carcinomas; alternatively, the disease could be due to a correlation between HTLV-1 and the human papillomavirus (HPV).

Resumen Antecedentes: La leucemia/linfoma de células T del adulto se clasifica como una neoplasia de células T CD4+ periféricas desencadenada por el virus linfotrópico de células T humanas tipo 1 (HTLV-1). Los síntomas típicos se asocian a la infiltración leucémica; sin embargo, también se ha descrito la manifestación atípica y exagerada de carcinomas verrugosos. Caso clínico: Se presenta el caso de una paciente con lesiones múltiples en piel, necrosis isquemica del hallux y linfadenopatías. se realizaron biopsias que reportaron carcinoma epidermoide verrugoso y linfoma cutáneo. Se detectó esplenomegalia y adenopatías en mesenterio, región retroperitoneal, y cadenas ganglionares de las extremidades. la medula ósea presentó hallazgos compatibles con leucemia/linfoma de células T y ELISA positivo para HTLV-1/2. Tratamiento y resultado: La paciente presentó buena respuesta inicial al esquema CHOP (ciclofosfamida, doxorrubicina, vincristina, prednisona) con filgrastim. Sin embargo, presentó recaída de la enfermedad antes del segundo ciclo y falleció Relevancia clinica: La comorbilidad podría conducir al modelo de factores de riesgo asociados. De acuerdo con este modelo, la inmunodeficiencia secundaria causada por HTLV-1 puede inducir el desarrollo de carcinomas verrugosos; Alternativamente, la enfermedad podría deberse a una correlación entre el HTLV-1 y el virus del papiloma humano (VPH).

Verrucous Carcinoma of the Eyelid

No abstract available.

Proliferative Veruccous Leukoplakia: An Extensive Red and White Lesion.

Proliferative verrucous leukoplakia (PVL) is a rare form of leukoplakia, which was first described by Hansen et al. in the year 1985. PVL is a disease with aggressive behavior due to its high rate of recurrence and a high rate of malignant transformation, usually more than 70%. This is a long-term progressive condition, which is observed more frequently in females over the age of 60 years. In the course of time, PVL tends to become multifocal with progressive deterioration of the lesions, making it more and more difficult to control. Unlike other cases of leukoplakia, tobacco use does not seem to have a significant influence on the appearance and progression of PVL. As this condition is seen in non-smokers, the etiology of PVL remains unclear making the management and diagnosis difficult. The aim of this article is to present a case which is diagnosed based on the diagnostic criteria proposed by Cerero-Lapiadra et al.

Epitelioma cuniculatum plantar / Epithelioma cuniculatum plantare

El epitelioma cuniculatum es una forma rara de carcinoma escamocelular bien diferenciado que afecta el pie, presenta una evolución crónica con crecimiento lento, muy agresivo localmente pero con bajo potencial metastásico, requiere resección quirúrgica amplia con amputación. Se presenta el caso de un hombre de 55 años con una lesión de aspecto verrucoso de cinco años de evolución, localizada en la planta del pie derecho.

The epithelioma cuniculatum is a rare form of well differentiated squamous cell carcinoma that affects the foot, it displays a chronic evolution with slow growth, very aggressive locally but with low metastatic potential, requires ample surgical resection with amputation. The case of a 55 years old man with a tumor of verrucous aspect of 5 years of evolution, located in the plant of the right foot appears.

Condiloma acuminado gigante (tumor de Buschke-Lowenstein): presentación de un caso / Giant acuminated condiloma (Bushke-Lowenstein tumor): case report

El condiloma gigante del pene o tumor de Buschke-Lowenstein, es un tumor epitelial benigno de origen viral y sexualmente transmisible, que en raros casos puede malignizar. Su histología se caracteriza por papilomatosis y acantosis endo y exofítica. Existen diferentes tratamientos del tumor, pero el más efectivo es la resección quirúrgica radical para evitar recidivas y malignización. Describir y documentar un caso de un condiloma acuminado gigante o tumor de Buschke-Lowenstein. Revisaremos la bibliografía existente sobre este tipo de tumor. Paciente masculino de 51 años de edad con lesiones vegetantes de 6 años de evolución, que se extienden desde la región perianal a perineal y ambas regiones inguinales, escroto y base de pene, a quien se le realizó resección quirúrgica amplia de la lesión. El estudio anatomopatológico reporta condiloma acuminado gigante, con inflamación crónica severa sobre agregada, el paciente mantiene resultados funcionales y estéticos muy satisfactorios después de la cirugía. El tumor de Buschke-Lowenstein es un condiloma acuminado gigante que se presenta con más frecuencia en hombres, benigno, cuyas lesiones clínicas son mayores de 10 cm, por lo que el tratamiento de elección debe ser siempre quirúrgico.

The giant condyloma of the penis or denominated Buschke-Lowenstein tumor is a benign epithelial tumor of viral origin and its sexually transmissible, in rare cases can become transformation to malignant. Histology is characterized by papillomatosis and acanthosis endophytic and exophytic. There are different treatments of the tumor, but the most effective of them is the radical surgical resection to prevent recurrences and the malignant transformation of the lesion. To describe and document a case view of us in our institution of giant condyloma acuminatum or Buschke-Lowenstein tumor. We will review the existent literature on this type of tumor. Male patient 51 years old with vegetative lesions of 6 years of evolution, extending from the perineal and per anal region to groins, the scrotum and the penis base, who underwent extensive surgical resection treatment. The pathology reports giant condyloma acuminatum with severe chronic inflammation, actually the patient maintains satisfactory functional and aesthetic results after the surgery. The Buschke-Lowenstein tumor is a giant condyloma acuminated it´s occurs more often in men, benign clinical lesions which are greater than 10 cm, so the treatment of choice should always be the surgical.

Carcinome verruqueux du larynx : Diagnostic et traitement

Introduction : Les carcinomes verruqueux du larynx sont des tumeurs rares. Ils posent des problemes diagnostics et therapeutiques. Le but de notre travail est de detailler les difficultes diagnostiques et therapeutiques du carcinome verruqueux du larynx. Patients et methodes : Treize malades ont ete traite d'un carcinomes verruqueux du larynx entre 1992et 2007. Resultats : Une chirurgie a ete pratiquee pour dix patients dont 7 ont eu un curage ganglionnaire. Deux patients etaient traites par radiotherapie exclusive et un autre par radio chimiotherapie concomitante. L'evolution etait bonne sans recidive ni metastases chez tous les patients qui ont ete traites chirurgicalement avec un recul moyen de 37 mois. Conclusion : Le carcinome verruqueux du larynx est une forme rare; de bas grade et bien differenciee du carcinome epidermoide. Il s'agit d'une tumeur a croissance lente et localement agressive dont le traitement de choix est l'exerese chirurgicale en marges saines

Carcinoma verrucoso da mão: uma rara apresentação avaliada por ressonância magnética / Verrucous carcinoma of the hand: a rare presentation evaluated by magnetic resonance imaging

O carcinoma verrucoso é uma variante do carcinoma de células escamosas, vista em mucosas e pele, raramente encontrada na mão. Nós relatamos um caso de duas lesões no dorso da mão, sem contato entre si, que foram ressecadas em bloco e confirmadas como carcinoma verrucoso.

Verrucous carcinoma is a variant of squamous cell carcinoma seen in mucous membranes and skin, and rarely found in the hand. The present report describes a case of two lesions on the dorsum of the hand, with no contact to each other, which underwent en-block resection and were confirmed as verrucous carcinoma.

Carcinoma verrucoso oral: reporte de un caso clínico y revisión de 20 casos del Instituto de Referencia en Patología Oral (IREPO), Chile / Oral verrucous carcinoma: a case report and review of 20 cases of the Oral Pathology Referral Institute (IREPO), Chile

El carcinoma verrucoso (CV) es una variante rara del carcinoma de células escamosas con características morfológicas y comportamiento específico. El presente estudio relata el caso de una paciente de género femenino, de 68 años de edad, que presenta un carcinoma verrucoso en lengua, indoloro y con 8 meses de evolución. Además, se realizó una breve revisión de casos clínicos del Instituto de Referencia en Patología Oral (IREPO) de la Facultad de Odontología de la Universidad de Chile, diagnosticados entre enero de 1984 y octubre de 2010, encontrándose 20 casos, con un promedio de edad de 70 años, localizados con mayor frecuencia en encía inferior y lengua.

Verrucous carcinoma (VC), a rare variant of squamous cell carcinoma is an established entity with distinctive morphology and specific clinical behavior. The present study describe a case report of a 68-year-old women who presented a tongue verrucous carcinoma, asymptomatic, that had about 8 months of evolution. A brief review of VC cases diagnosed in Oral Pathology Referral Institute (IREPO), Faculty of Odontology, University of Chile, between 1984 and 2010. It was found 20 cases of verrucous carcinoma with a median age of70-years-old, the most common places were lower gingiva and tongue.

Carcinoma verrugoso de Ackerman / Ackerman verrucous carcinoma

El carcinoma verrugoso, tumor de Ackerman o papilomatosis florida, es una variedad bien diferenciada del carcinoma de células escamosas. Fue descrito por primera vez en 1948 por Lauren Ackerman (Francia), el que observó que dicho tumor presentaba apariencia morfológica característica y un comportamiento clínico específico, por lo que debía ser separado de los otros carcinomas de células escamosas. Se lo atribuye al consumo del tabaco en sus diferentes formas, la responsabilidad en la aparición de esta lesión, sumándose otros factores irritntes crónicos locales. Actualmente se le otorga gran importancia al VPH (virus papiloma humano), principalmente al tipo 16, por estar presente en el 98 por ciento de las lesiones; queda por dilucidar si tiene función pirmaria en la etiología de la lesión o es un agregado posterior. Presentamos un caso de carcinoma verrugoso de Ackerman en la mucosa bucal, en un paciente varón de 51 años con historia de consumo de tabaco, alcohol y coqueo con bicarbonato de sodio durante larga data. Se describen las manifestaciones clínicas, histopatológicas y el control posterior a los 5 años.

Verrucous carcinoma of vulva.

Vulval carcinoma is an uncommon disease of old women and may manifest as verrucous carcinoma. Intraepithelial cancer of the vulna of women in their twenties and thirties is increasing. Invasive carcinoma of vulva usually appears long time after intraepithelial neoplasia or chronic irritation. We are presenting one young lady of 21 years who noticed whitening of vulva since her childhood and irregular vulval itching in that area. After nine to ten years she further noticed swelling in that area which used to discharge off an on along with itching. As she got married and had disturbed sexual life, on consulting with a specialist doctor, the lesion was diagnosed as an ulcerated malignant growth. Further investigation revealed the lesion to be as verrucous carcinoma of vulva. This is the first report of such case in our country. Any persistent complaints of vulva like itching, discharge, even ulcer should be taken care of for detection of intraepithelial vulvar cancer.

[Histopathological differentiation between well differentiated oral squamous cell carcinoma and oral verrucous carcinoma with special staining of basement membrane]

Microscopic differentiation between well differentiated squamous cell carcinoma and verrucous carcinoma is very difficult. As these lesions have different clinical course and treatment a reliable method to help distinguish between them is necessary. The basement membrane in oral verrucous carcinoma is generally intact whereas in oral squamous cell carcinoma is mostly discontinuous. This structure can be studied by different methods. The aim of this study was to differentiate these lesions with special staining of basement membrane. In this tests evaluation study, a total of 26 cases consisting of 15 oral squamous cell carcinomas and 11 oral verrucous carcinomas were retrieved from Cancer Institute of Imam Khomeini hospital archive of pathology and their paraffin blocks were cut and stained with Periodic Acid Schiff method. Slides were studied with light microscope to evaluate the continuity of basement membrane. Sensitivity and specificity of this method were calculated. The sensitivity of this method for differentiating oral squamous cell carcinoma from oral verrucous carcinoma was 100% whereas the specificity was 90.9%. Positive predictive value was 93.75% and negative predictive value 100%. Based on the results of this study, the sensitivity of this test for diagnosis of oral squamous cell carcinoma was high [100%]. Further studies are needed to evaluate the use this method for distinguishing oral verrucous carcinoma from oral squamous cell carcinoma

Sinonasal verrucous carcinoma with oral invasion.

Verrucous carcinoma is a rare warty variant of squamous cell carcinoma, most often seen in the oral cavity and larynx. Its occurrence in the sinonasal tract is rare. This tumor constitutes approximately 1% of all sinonasal neoplasms. The clinical presentation and the histopathological features of verrucous carcinoma are a subject of continuous discussion amongst diagnosticians and pathologists. A case with oral and nasal presentation of this tumor is reported here.

comparison study of AgNORs staining in human oral normal mucosa verrucous carcinoma and squamous cell carcinoma

The value of Silver Staining of nucleolar organizer regions [AgNOR] counts as a diagnostic aid has been reported for several neoplastic entities. The aim of this study to determine the evaluation of the expression of AgNOR as a marker of proliferation in squamous cell carcinoma grade I, verrucous carcinoma and oral normal mucosa. Silver-Stain nucleolar organizer regions AgNORs were counted in sections from formalin fixed paraffin embedded blocks of 20 cases of well-differentiated squamous cell carcinoma, 20 cases of verrucous carcinoma and 10 cases of normal oral mucosa. Two methods of AgNORs counting were used. The mean number of AgNOR nucleus [M AgNORs] and determination cells containing 3 or more AgNORs/ nucleus [P AgNOR] as indicator of the proliferative activity of the cells. Statistical differences were found between normal oral mucosa, verrucous carcinoma WD squamous cell in AgNOR related parameters. AgNOR would be a quantitative, discriminative aid, easy to monitor in a pathology laboratory in detection incipient cellular alterations and contribute to the issue of early diagnosis and to the knowledge of tumoral growth

Carcinoma escamoso de células fusiformes asociado a carcinoma verrucoso en laringe: presentación de caso / Laryngeal spindle cell carcinoma associated with verrucous carcinooma. case presentation

El Carcinoma fusocelular de laringe, es una variante infrecuente del carcinoma de células escamosas, que forma parte de los tumores de vías aero-digestivas superiores con estirpe histológica mixta. Su asociación con el carcinoma verrucoso en el mismo espécimen quirúrgico es excepcional. Presentamos el caso de un paciente portador de esta duplicidad neoplásica, y aprovechamos para revisar el concepto y su dificultad diagnóstica, así como su tratamiento y evolución, que están supeditados al de la variante histológica de mayor agresividad.Palabras clave: Carcinoma fusocelular. Carcinoma verrucoso. Laringe.

Localized hyperkeratotic scabies in a patient with Down syndrome simulating verrucous carcinoma

É apresentado um paciente de Salvador, Bahia, com síndrome de Down e escabiose hiperqueratósica localizada

Carcinoma verrucoso del cuello uterino / Verrucous carcinoma of the uterine cervix

El carcinoma verrucoso corresponde a una variante del carcinoma escamoso bien diferenciado. En el tracto genital femenino la región más comprometida es la vulva y raramente se presenta en el cuello uterino. Desde su descubrimiento ha presentado una serie de denominaciones, lo que ha dificultado su estudio. Se caracteriza por ser de lento crecimiento e invadir localmente casi sin metastizar a distancia. Su tratamiento es quirúrgico, siendo radiorresistente. Se plantea el diagnóstico diferencial con el carcinoma papilar de células escamosas y la condilomatosis cervical. En la literatura mundial se describen no más de 33 casos en esta localización, por lo que se expone nuestra experiencia además de compararla con la información disponible al respecto