Oral verrucous lesions: Controversies in diagnosis and management

Abstract

Accurate diagnosis of the verrucous lesions is important and should be differentiated from grade I squamous cell carcinoma. Management should be based upon the nature, behaviour and malignant potential of the lesion.

A population‐based analysis of verrucous carcinoma of the oral cavity

“…Mehrotra et al described orthokeratinization, stratum corneum without nuclei, as a feature more commonly associated with VH; whereas parakeratinization, or stratum corneum with retained nuclei, is more frequently seen in VC, among other characteristics. 27 Shear and Pindborg similarly described deep epithelial projections into subcutaneous tissue without invasion in VC as compared with superficial projections in VH. 28 To complicate the diagnostic pursuit, recent studies have demonstrated the poor reliability of incisional biopsy to reach a diagnosis of VC and the notable possibility of hybrid neoplasms within lesions.…”

“…The possibility of misdiagnosing VC as verrucous hyperplasia (VH) or squamous cell carcinoma is quite plausible given similar histopathologic characteristics. Mehrotra et al described orthokeratinization, stratum corneum without nuclei, as a feature more commonly associated with VH; whereas parakeratinization, or stratum corneum with retained nuclei, is more frequently seen in VC, among other characteristics . Shear and Pindborg similarly described deep epithelial projections into subcutaneous tissue without invasion in VC as compared with superficial projections in VH .…”

Verrucous Hyperplasia: Case report and differential diagnosis

“…17 In terms of treatment modality, surgery alone is the most common method of management for both VC and VH cases, due to their overlapping clinicopathological features. 18,19 However, it is important to ensure wide surgical excision of the lesion with adequate soft tissue margins so as to avoid recurrence. Although sporadic cases of cervical and distant metastasis have been reported, the overall rate of metastasis is insignificant.…”

Oral Verrucopapillary Lesions: A Diagnostic Conundrum

“…It usually presents as a verrucous pattern and in some conditions, may show polypoid, sessile or papillomatous appearance (Table 3). 8,9 and Verruciform xanthoma 7,9 Seborrheic keratosis 4,5,9 Exophytic papillary squamous cell carcinoma 2,3,9 Verrucous carcinoma 9,10 Common site Clinical presentation Histopathology Refer Table 1 Although it is a rare lesion, it may occur in buccal mucosa and lip…”

“…Squamous papilloma [4][5][6] Verruciform xanthoma 7 Verruca vulgaris 8,9 Heck's disease 4,5 Pyogenic granuloma 4,5…”