Top 10 Symptoms of Verrucous Carcinoma You Shouldn't Ignore

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma that tends to grow slowly but can cause significant damage to the tissues where it develops. Because of its slow-growing nature, VC may not immediately present with alarming symptoms, making it easy to overlook. However, understanding the common signs and symptoms can help detect the condition early and ensure timely treatment.

Here's a breakdown of the top 10 symptoms of verrucous carcinoma you shouldn't ignore, particularly if they persist or worsen over time.

1. Wart-Like Growth

One of the hallmark symptoms of verrucous carcinoma is the presence of a wart-like growth in areas such as the oral cavity, genitals, feet, or other regions where mucous membranes meet the skin. These growths often appear thick and bumpy, resembling warts or verrucae, which can make them hard to differentiate from benign skin lesions.

While they may not cause discomfort initially, their persistent nature is a red flag. Unlike regular warts, VC lesions do not go away on their own and may grow slowly over time. If you notice a wart-like growth that seems resistant to treatment or continues to increase in size, it's essential to get it checked by a healthcare professional.

2. Thickened, Scaly Skin

In areas where VC develops, the skin may become thickened or scaly. This symptom is more commonly seen in verrucous carcinoma of the feet (epithelioma cuniculatum), where the growths may cause the affected area to harden and feel rough. While this thickening is often painless in the early stages, it can eventually lead to discomfort, particularly when the affected area is subject to pressure or friction.

If you notice an area of skin that has become thickened or rough, especially if it's on the soles of your feet or other commonly affected areas, it's important not to ignore this change.

3. Ulceration or Open Sores

Although verrucous carcinoma typically presents as a slow-growing, wart-like growth, some cases may lead to ulceration or the development of open sores. These sores may occur if the tumor becomes irritated or damaged, leading to the breakdown of the skin's surface.

Unlike common ulcers or sores that heal with time, those associated with VC tend to persist and may even worsen. Any non-healing sore, especially if it appears in the mouth, genitals, or feet, should be evaluated by a healthcare provider to rule out the possibility of VC or other skin cancers.

4. Persistent Redness or Irritation

As VC progresses, the surrounding skin or mucous membrane may become irritated, resulting in persistent redness. This irritation can occur due to the tumor's growth or friction against nearby tissues. In oral verrucous carcinoma, for instance, the gums or inner cheeks may become red and inflamed, particularly around the area of the tumor.

Persistent redness, especially in the absence of other clear causes like infection or trauma, is a warning sign that should not be dismissed. If the redness doesn't improve or worsens over time, further evaluation is necessary.

5. Pain or Discomfort

While VC often starts as a painless growth, discomfort may develop as the tumor grows and affects surrounding tissues. Pain is more likely to occur in cases where the tumor becomes ulcerated or when it invades deeper structures.

For example, in oral verrucous carcinoma, the growth may cause discomfort while eating or speaking. In genital or plantar VC, the tumor may cause pain during sexual activity, walking, or other physical activities. If you notice a growth that begins to cause pain, even if it was previously painless, it's a symptom that warrants immediate attention.

6. Bleeding from the Lesion

Another symptom that can develop with VC is bleeding from the affected area. This typically occurs when the surface of the tumor becomes ulcerated or irritated, leading to damage to the blood vessels in the area. Bleeding is more common in oral or genital verrucous carcinoma, where the tumor is exposed to friction from talking, eating, or physical contact.

Any unexplained or persistent bleeding from a wart-like growth should prompt a visit to a healthcare provider. In some cases, bleeding may be the first sign that the lesion is not benign.

7. Changes in Texture or Appearance of the Growth

Over time, the texture or appearance of the verrucous carcinoma lesion may change. What might start as a smooth, wart-like growth can become rougher, thicker, or more irregular. This change is particularly noticeable in plantar VC, where the lesion can evolve from a small, benign-looking wart to a large, callus-like growth.

If you notice any significant changes in the appearance of a wart or thickened area of skin, especially if it seems to be growing or changing shape, it's crucial to seek medical advice. These changes may indicate that the growth is becoming more aggressive or spreading into deeper tissues.

8. Bad Odor (In Advanced Cases)

In some advanced cases of verrucous carcinoma, particularly in lesions that become ulcerated or infected, a foul odor may develop. This can occur due to the breakdown of tissue or the presence of bacteria in the ulcerated area. This symptom is more commonly seen in genital or plantar VC, where the lesion is more likely to become infected due to the location.

If a growth starts to emit an unpleasant odor, especially if it's accompanied by other symptoms like pain, bleeding, or discharge, it's a sign that the tumor may be progressing and requires prompt medical attention.

9. Difficulty with Function (Eating, Walking, or Sexual Activity)

As verrucous carcinoma grows and invades nearby tissues, it can impair the function of the affected area. For example:

If a lesion begins to interfere with normal functions, it's important to seek medical advice as soon as possible. Delaying treatment can result in more significant functional impairment and tissue damage.

10. Recurrence After Treatment

While VC is less likely to metastasize compared to other forms of SCC, it has a high rate of local recurrence if not completely removed. If you've previously had a wart-like growth treated or removed and notice it coming back in the same area, this could be a sign of verrucous carcinoma.

Recurrence can occur months or even years after the initial treatment, especially in cases where the tumor was not fully excised. If you experience a recurrence, it's crucial to follow up with a healthcare provider for further evaluation and treatment.

When to See a Doctor

Verrucous carcinoma is a rare but serious condition that requires medical intervention. If you notice any of the symptoms mentioned above, particularly if they persist or worsen, it's essential to consult a healthcare provider. Early diagnosis and treatment can significantly improve the outcome, and in many cases, the growth can be removed surgically with minimal risk of recurrence.