Treatment of an epithelioma cuniculatum plantare by local excision and a plantar skin flap

Atypical presentation of verrucous carcinoma: a case study and review of the literature

Verrucous carcinoma is a slow-growing lesion that is most often found on the weight-bearing surface of the foot and should be considered in the differential diagnosis for chronic nonhealing wounds in the diabetic neuropathic population. Accurate diagnosis may be difficult initially and often requires repeat histopathologic evaluation by an experienced pathologist. Verrucous carcinoma can invade deeper tissues; however, extension to bone is a rare occurrence. The authors present a case report of an atypical verrucous carcinoma on the dorsal aspect of the foot and a review of the literature. Studies suggest that multiple therapies exist and recurrence does occur; however, this is less likely with wide excision and more so with Mohs' surgery. With a high clinical suspicion and thorough histopathologic exam, bone involvement and amputation may be avoided.

LEVELS OF EVIDENCE

Therapeutic, Level IV.

Carcinoma cuniculatum of the jaw: a rare variant of oral carcinoma

Carcinoma cuniculatum is a rare variant of carcinoma usually involving the foot. Only 13 cases have been described in the oral cavity, none of which was in the English-language literature. We describe a 56-year-old man who presented with a soft exophytic mass in the maxillary gingiva, alveolar bone destruction, and loosening of the teeth. Histopathologic study revealed thin papillary projections covered by a thick keratin layer in the superficial areas and multiple, branching keratin-filled crypts surrounded by well-differentiated squamous epithelium with only mild cytologic atypia but frequent mitosis. Immunohistochemistry results of p53 and polymerase chain reaction analyses for human papillomavirus 6, 11, 16, and 18 DNA were negative. The diagnosis was carcinoma cuniculatum of the jaw. The literature on this unusual oral pathosis is reviewed and the diagnostic challenge described. We suggest that carcinoma cuniculatum may sometimes be misdiagnosed as squamous cell carcinoma or verrucous carcinoma and, therefore, might be more prevalent than the small number of published cases implies.

Verrucous carcinoma of the foot: a review and report of two cases

Verrucous carcinoma is an uncommon form of squamous cell carcinoma. Clinical and histological features of this condition are reviewed. Excision is the treatment of choice due to local aggressiveness and infrequent metastasis. Two cases involving the foot are presented as well as a survey of previously documented cases of this condition.

Epithelioma cuniculatum (carcinoma cuniculatum) of the thumb: a case report and literature review

Epithelioma cuniculatum is a rare, slow growing, but locally destructive, low-grade epithelioma of squamous cell origin. The first case of this tumor occurring on the thumb is reported. Treatment of this case is discussed, the literature reviewed, and controversy surrounding the naming of this tumor is examined.

Microscopically controlled surgery (Mohs' chemosurgery) for treatment of verrucous squamous cell carcinoma of the foot (epithelioma cuniculatum)

In two cases of epithelioma cuniculatum, a rather rare form of verrucous carcinoma of the plantar surface of the foot, the lesions were excised by means of microscopically controlled surgery (Mohs' chemosurgery) with successful results, both clinically and cosmetically. Although the tumor is generally slow-growing and often mistaken for a plantar wart, it can cause extensive local destruction. Metastasis has been reported and may be related to anaplastic transformation caused by radiotherapy. In certain cases, amputation may possibly be avoided through the use of microscopically controlled surgery.

Carcinoma (epithelioma) cuniculatum: a clinico-pathological study of nineteen cases and review of the literature

Nineteen patients with carcinoma cuniculatum are presented. Of these, 17 were male and two were female. The age range was from 26 to 73 years with a mean of approximately 54 years. Sixteen tumours were located on the foot, the other three were situated on the knee, wrist and finger respectively. The pathological features of carcinoma cuniculatum are described and the aetiology of the tumour is discussed.

Verrucous carcinoma of the foot

A 50-year-old man presented with verrucous carcinoma on the sole of the foot. This unusual tumor, also called an epithelioma cuniculatum plantare, was successfully treated employing wide surgical excision.