Surgical treatment of verrucous carcinoma: a review

Abstract

Background

Verrucous carcinoma is a rare mucocutaneous malignancy characterized by slow, relentless growth and a low metastasis rate.

Objective

Herein we summarize surgical success rates and review newer approaches to the treatment of verrucous carcinomas.

Methods and Materials

PubMed electronic searches were performed by B.F. and C.V. using combinations of the following terms: “verrucous carcinoma,” “Ackerman tumor,” “Buschke Lowenstein,” “epithelioma cuniculatum,” “carcinoma cuniculatum,” “papillomatosis cutis,” “treatment,” “therapeutics,” “management,” “mohs surgery,” and “excision.” A systematic review was conducted on 49 articles in accordance with PRISMA guidelines.

Results

Surgical management remains first-line therapy. Wide local excision is most commonly utilized, with highly variable margins (0.5–3.0 cm) and recurrence rates (4.6–75.0%). Mohs Micrographic Surgery has also been used, especially for recurrent tumors, with an overall recurrence rate of 12.9%.

Conclusion

Surgery is the treatment of choice, either by Mohs Micrographic Surgery or wide local excision. However, surgical recurrence rates are high, and tissue-sparing therapies are desirable given the sensitive locations involved. Ultimately, randomized control trials are needed to develop evidence-based guidelines for the management of VCs.

Keywords:

• Verrucous carcinoma
• mohs surgery
• excision
• recurrence

Disclosure statement

The authors report no conflict of interest.