Skin - Nonmelanocytic tumors
Carcinoma (non-adnexal)
Verrucous carcinoma

Author: Ghassan Tranesh, M.D. (see Authors page)
Editor: Hong Qu, M.D.

Revised: 13 October 2016, last major update November 2014

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Verrucous carcinoma [title] skin

Cite this page: Verrucous carcinoma. website. Accessed October 28th, 2016.
Definition / General
  • Verrucous carcinoma describes a low grade squamous cell carcinoma affecting skin and mucosa with characteristic slow growth, minimal local invasion and only rare metastases
  • Suspect if a longstanding verrucous lesion is unresponsive to routine treatment (Indian Dermatol Online J 2014;5:218)
  • Most cases (90%) are found on the feet (Indian Dermatol Online J 2014;5:218)
  • Pathophysiology
    • Risk factors include chronic inflammation or irritation, human papillomavirus (HPV) infection
    • For oral cavity, risk factors also include betel nut chewing, smoking,
    Case Reports
    • Surgical excision, cryosurgery, carbon dioxide laser, chemotherapy, intralesional or iontophoretic methods, photodynamics therapy, systemic retinoid therapy, radiotherapy
    Clinical Images

    Images hosted on other servers:

    Finger tumors

    Vulvar tumor

    Heel tumor

    Gross Description
    • Ulcerating, fungating or polypoid mass with sinus tracts opening onto skin surface
    Micro Description
    • Epidermis with hyperkeratosis, papillomatosis, hypergranulosis, acanthosis
    • Rete ridges are bulbous with "bulldozing" pattern
    • Deeper biopsy shows broad bands of epidermal proliferation with parakeratotic centers; bases of proliferation are large and bulbous and invade deep dermis in a pushing manner
    • Minimal atypia (Indian Dermatol Online J 2014;5:218)
    Micro Images

    Images hosted on Flickr:

    Courtesy of Dr. Asmaa Gaber Abdou

    Images hosted on other servers:

    Low grade tumor with broad pushing border



    Extravasated erythrocytes

    Keratin pearls

    Positive Stains
    • HPV (frequently, usually 16, 6, 11)
    Differential Diagnosis
    • Benign keratoses
    • Cysts
    Additional References