Skin nonmelanocytic tumor

Carcinoma (nonadnexal)

Verrucous carcinoma

Topic Completed: 1 November 2014

Minor changes: 25 October 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Verrucous carcinoma [title] skin

Ghassan A. Tranesh, M.D.
Hong Qu, M.D.
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Cite this page: Tranesh G. Verrucous carcinoma. website. Accessed October 25th, 2021.
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
    Microscopic (histologic) 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)
    Microscopic (histologic) images

    Contributed by Asmaa Gaber Abdou, M.D.

    Verrucous carcinoma

    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
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