Verrucous carcinoma

Overview
Verrucous carcinoma is a variant of squamous cell carcinoma. This form of cancer is often seen in those who chew tobacco or use snuff, so much so that it is sometimes referred to as "Snuff dipper's cancer." It is also known as an Ackerman tumor.

Most patients with verrucous carcinoma have a good prognosis. Local recurrence is not uncommon, but metastasis to distant parts of the body is rare. Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma, for which the prognosis is worse.

Definition
It’s a diffuse, papillary, non metastasizing, well differentiated, malignant neoplasm of epidermis of oral epithelium. It is also known as an Ackerman tumor.

Etiology
This form of cancer is often seen in those who chew tobacco or use snuff, so much so that it is sometimes referred to as "Snuff dipper's cancer."

Clinical features

 * age- usually over 60 yrs
 * sex- males are more prone
 * site- gingiva, buccal mucosa, alveolar mucosa, hard palate, floor of the mouth, larynx, oesophagus, penis, vagina, scrotum.
 * clinical presentation-
 * It’s a slow growing, diffuse, exophytic lesion usually covered by Leukoplakik patches.
 * Invasive lesions quickly invade bones
 * It is rapidly become fixed with underlying periosteum and cause gradual destruction of jaw bone.
 * Enlarged regional lymph nodes
 * Lesion shows painful multiple rugae like folds and deep clefts between them.

Differential diagnosis

 * Papillary hyperplasia
 * Verrucous leukoplakia
 * Squamous cell carcinoma

Treatment
Surgical excision or laser therapy