Epithelioma Cuniculatum Pedis, a Variant of Squamous Cell Carcinoma

Abstract

The rare lesion of epithelioma cuniculatum pedis may be recognized by the gross appearance of a slow-growing, bulky, "squashy," non-healing, exophytic mass of long duration on the sole, exuding foul-smelling purulent keratin debris from numerous sinuses, and biopsies showing extensive infiltrating plaques of keratinizing, well-formed, squamous epithelium forming walls for numerous sinuses filled with purulent material. The rarity of the lesion, the slow growth, and biopsies showing relatively benign-appearing well-differentiated squamous epithelium caused considerable diagnostic difficulty to clinicians and pathologists. The tumor failed to heal, extensively penetrated the soft tissues, ultimately destroyed the metatarsal bones, and invaded the skin of the dorsum of the fott. The lesion should be treated as a slow-growing, well-differentiated squamous cell carcinoma by wide local excision or by amputation when extensive growth causes deformity of the foot or penetration of the metatarsal bones.

Clinicopathological evaluation of carcinoma cuniculatum: a variant of oral squamous cell carcinoma

“…A VC lesion is usually limited to the lamina propria, while CC may penetrate deeply into the submucosa and bone. The latter was seen in a case within the gingivae, which was similar to plantar CC (2, 26). In addition, CC shows the characteristic sinuous‐burrowing pattern and compromising cuniculatum architecture that is absent in VC, which has a better prognosis without rare metastasis.…”

Carcinoma Cuniculatum of the Buttock

“…20], Other cases were not identified as verrucous carcinoma, either due to the lack of a verrucous appearance [21] or because carcinoma cuniculatum has a more destructive and penetrative characteristic than usual verrucous carcinoma [22].…”

Dermatopathology in Historical Perspective: Epithelioma Cuniculatum (Aird)

“…6 The clinical lesion on the left foot had been present and enlarging slowly for 20 years. Instead of fine, intertwining sinuses lined by single strands of cells that join toward the surface-like rivers draining a marsh, there is a markedly papillomatous surface with keratotic invaginations lined by thick layers of well-differentiated keratinocytes.…”