Oral Hybrid Verrucous Carcinoma: A Clinical Study

Abstract

Hybrid Verrucous Carcinoma is an uncommon tumour wherein Verrucous Carcinoma (VC) is coexisting with conventional Squamous Cell Carcinoma (SCC) within same maternal field. The heterogeneous nature, infrequency of occurrence and the difficulties associated with diagnosis and management of this tumor is discussed through a retrospective study. Patients of primary hybrid VC treated from Jan 2010 to May 2013 at a tertiary institute were analyzed on multivariate cox regression model. During the above mentioned period; 37 patients of hybrid VC were reported; 18(48.6 %) were male and 19(51.3 %) were female. Age ranged between 33 years to 78 years. Median follow up period was 32 months. T stage status and Stage grouping was not statistically significant for mortality (p value: 0.338). In the multivariate cox-regression model, the presence of second primary oral cancer was significantly associated with mortality, adjusted HR; 23.10 (95 % CI: 1.73, 307.65) (p=0.017). Tumour staging is often unreliable in predicting prognosis of hybrid VC, occurrence of second primary oral cancer and recurrence appears to be significant factors effecting prognosis.

Oral verrucous carcinoma: From multifactorial etiology to diverse treatment regimens (Review)

“…Oral hybrid verrucous carcinoma (VC) is a neoplasm composed of OVC and differently-differentiated OSCC (85). For example, welldifferentiated OSCC was identified within OVC and invaded the underlying connective tissue and bone (76).…”

Oral verrucous carcinoma: a diagnostic and therapeutic challenge

“… 33 Although multiple biopsies from different areas of the tumour might be helpful to identify invasive component, surgical excision and histopathological examination of whole resection specimen is needed for definitive diagnosis. 32 If hybrid verrucous carcinoma is recognized, the pathologist should quantitate each component of the tumour, define the degree of differentiation of the conventional SCC component and comment on depth of the tumour invasion, potential presence of lymphatic or perineural invasion and the adequacy of the resection margins. These features help the clinicians to decide about adjuvant treatment options.…”

“…Moreover, examination of small tumour samples obtained with biopsy could be misleading as an invasive component is often missed at sampling. 32 Gokavarapu et al reported that 51% of cases preoperatively diagnosed as oral FIGURE 1. Verrucous carcinoma of the right buccal mucosa (clinical stage T2N0M0) in an 81-year-old male patient.…”