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.
Disclosure statement
The authors report no conflict of interest.