Verrucous carcinoma (VC) is indeed a form of squamous cell carcinoma (SCC), but with unique characteristics that distinguish it from the more common forms of SCC. While both types of cancer originate from the squamous cells - the flat, scale-like cells that make up the lining of many parts of the body - verrucous carcinoma exhibits different behavior in terms of growth, appearance, and aggressiveness.
Squamous cell carcinoma is the second most common form of skin cancer and can also occur in mucosal tissues, such as those in the mouth, throat, and genital areas. Typically, SCC grows more rapidly than basal cell carcinoma and can invade surrounding tissues or metastasize to other parts of the body. It often appears as rough, scaly patches, open sores, or wart-like growths.
While verrucous carcinoma is classified as a variant of squamous cell carcinoma, it is notably different in several ways:
In histopathology, verrucous carcinoma is often referred to as a "well-differentiated" variant of SCC. This means that, under a microscope, the cancer cells look relatively similar to normal squamous cells, and they tend to grow in a more organized pattern compared to poorly differentiated cancers. This also partly explains why verrucous carcinoma grows slowly and is less likely to metastasize.
Despite its slower growth, verrucous carcinoma can still be quite aggressive locally. If left untreated, it can invade deeper tissues, including muscles and bones, leading to significant disfigurement or functional impairment, particularly when located in sensitive areas like the mouth or genitals.
While VC is a form of SCC, the distinction between the two is important for several reasons:
Treatment Options: Verrucous carcinoma tends to respond differently to treatment than more typical forms of SCC. For instance, radiation therapy, which is commonly used to treat SCC, is sometimes less effective for VC and may even worsen the condition in some cases. Surgery is often the preferred treatment for VC, as it allows for the complete removal of the tumor.
Prognosis: The prognosis for verrucous carcinoma is generally better than for SCC, primarily because it is less likely to metastasize. However, its tendency to grow locally and invade surrounding tissues can make surgical excision challenging, especially in advanced cases.
Follow-Up Care: Because VC is slow-growing but persistent, patients require careful long-term monitoring to detect any signs of recurrence. Even after successful treatment, verrucous carcinoma has a higher chance of returning than typical SCC, making follow-up care essential.
Verrucous carcinoma can develop in several areas of the body where squamous cells are present. The most common locations include:
Oral Cavity: Verrucous carcinoma in the mouth is often associated with chronic irritation, such as from tobacco chewing or poorly fitting dentures. It commonly appears on the gums, tongue, and buccal mucosa (inner cheek).
Genitals: In the genital area, VC can be found in both men and women, often related to HPV infection. It may occur on the penis, vulva, or in the perianal region.
Feet and Soles: On rare occasions, VC can develop on the soles of the feet, where it may resemble a plantar wart. This form of verrucous carcinoma is sometimes mistaken for other non-cancerous growths, delaying diagnosis.
Diagnosing verrucous carcinoma requires a thorough clinical examination and biopsy. Due to its similar appearance to benign conditions, such as warts or papillomas, VC is often misdiagnosed early on. A biopsy is essential to confirm the presence of cancerous cells and to distinguish VC from other forms of SCC.
Once diagnosed, the treatment plan is based on the size, location, and extent of the tumor. Surgery is the most common approach to treatment, and depending on the tumor's location, other modalities, such as laser therapy, cryosurgery, or Mohs surgery, may be used to minimize tissue damage.
While verrucous carcinoma grows slowly, early detection is crucial to prevent extensive local invasion. Since it can be mistaken for other less serious conditions, it's essential to seek medical evaluation if you notice any persistent growths, particularly in the mouth, genitals, or soles of the feet.
Regular check-ups, especially for those at higher risk (e.g., smokers, individuals with HPV infections), can increase the likelihood of catching verrucous carcinoma in its early stages when treatment is most effective.
Despite its low metastatic potential, verrucous carcinoma should not be underestimated. Its slow but invasive growth can lead to complications, such as the destruction of underlying tissues and significant disfigurement, particularly in sensitive areas like the mouth. However, with timely and appropriate treatment, most individuals can expect a good prognosis, with a high likelihood of full recovery after surgery.