Verrucous Carcinoma
Verrucous carcinoma of the vulva is much less common than squamous cell carcinoma. The clinical and morphologic distinctions between these neoplasms are important to understand because of their contrasting biologic behavior and treatment. Verrucous lesions rarely metastasize.
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Both cancers present with symptoms of pruritus and a Noticeable mass. On examination, both tumors commonly occur on the labia and are exophytic. If infection occurs in association with verrucous carcinoma, the resulting induration of the surrounding tissue as well as reactive regional lymph Node enlargement may lead to an erroneous diagnosis of advanced squamous cell carcinoma. One third of squamous cell carcinomas are flat and ulcerative. It may be difficult to distinguish verrucous from squamous cell carcinomas.
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Verrucous carcinomas are thick neoplasms that may invade and compress the underlying stroma with pushing margins. Therefore, it is crucial to recognize the microscopic features of this well-differentiated squamous cell neoplasm so as Not to mistake it for a squamous cell carcinoma, which has the capacity to metastasize to inguinal lymph Nodes. Human papillomavirus has been implicated in the development of both of these tumors.
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The treatment of vermcous carcinoma is wide local excision. Because there may be recurrence if the surgical resection margins show signs of neoplastic involvement, the pathologist should carefully evaluate the margins. Recurrence of verrucous carcinoma connotes a poor prognosis.