Larynx, hypopharynx & trachea

Squamous cell carcinoma

Verrucous carcinoma

Topic Completed: 1 November 2013

Minor changes: 3 March 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Verrucous carcinoma [title] larynx

Nat Pernick, M.D.
Page views in 2020: 1,327
Page views in 2021 to date: 1,471
Cite this page: Pernick N. Verrucous carcinoma. website. Accessed December 8th, 2021.
Definition / general
  • 1 - 4% of laryngeal cancers
  • Has cytologic and architectural features normally associated with a reactive process but with ability to invade normal tissue
  • Locally destructive but almost never metastasizes; associated cervical adenopathy may be reactive and not metastatic disease
  • Usually men in 50s to 60s; associated with tobacco smoking or chewing
  • Occurs anywhere in upper aerodigestive tract
  • 5 year survival 78% (better after surgery than radiation therapy)
  • May coexist with conventional squamous cell carcinoma (if both present, must treat more aggressive component)
  • HPV negative
  • Difficult diagnosis to make, particularly from biopsies
  • Surgery; radiation not recommended in general since ineffective and may cause anaplastic transformation
Gross description
  • Large, white-tan exophytic tumor fixed to normal structures
  • Up to 10 cm; attached by broad base
Microscopic (histologic) description
  • Invasive cancer with well differentiated squamous epithelium that lacks features of squamous cell carcinoma
  • By definition has no dysplastic features above basal zone; uniform cells without atypia or mitotic figures
  • Marked surface keratinization (church spire keratosis), broad rete pegs with pushing but not an infiltrative margin
  • May have prominent lymphoplasmacytic and histiocytic infiltrate
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