Neck Dissection in Verrucous Carcinoma: A Surgical Dilemma.

ABSTRACT

Oral verrucous carcinoma (OVC) is a distinct low grade variant of squamous cell carcinoma (SCC) of the oral cavity. OVC is a rare tumor representing only 3-4% of all carcinoma. OVC is characterized by a slow growing, painless, broad based verrucous or wart like papillary lesion. Th e lesion lacks ulceration and has a propensity for local invasion rather than metastatic spread. Transformation of VC to anaplastic or poorly diff erentiated SCC is about 30-40%. Surgical excision with adequate margins of resection seems to be the clear preference for treatment. Th e need for neck dissection is an important consideration in planning therapy for OVC. Th e aggressive clinical presentation of the tumor often sways clinical judgment in favor of performing lymph node dissection, especially in the presence of clinical lymphdenopathy. It is reasonable to consider a selective neck dissection such as supra-omohyoid neck dissection in situations where there is uncertainty regarding the pathological diagnosis in the phase of clinically suspicious lymphdenopathy. Here we are presenting a case report of OVC in 65-year-old male patient treated with surgical excision and right side supra-omohyoid neck dissection.