Temporal Bone Verrucous Carcinoma: Outcomes and Treatment Controversy

Abstract

Verrucous carcinoma is a rare tumor that presents in the head and neck with the most common sites being the oral cavity and larynx. Fourteen cases of verrucous carcinoma of the temporal bone have been described in literature; this study aims to examine treatment outcomes and discuss the controversy surrounding postoperative radiation. The study design included a literature review along with individual case report in the setting of a tertiary care medical center. Outcome analysis of all cases of verrucous carcinoma of the temporal bone, which are documented in the English literature, and presentation of a single patient report including gross, histologic and radiologic analyses were performed. The longest recorded survival for verrucous carcinoma of the temporal bone occurs in patients treated with surgery alone. Poorer outcomes for patients treated with adjuvant (chemo)radiation may be due to more advanced stage of disease at the time of treatment. Early reports of radiation leading to tumor dedifferentiation or early recurrence are not supported by more recent studies. Whether adjuvant radiation therapy is indicated in verrucous carcinoma of the temporal bone remains controversial.

A Case of Squamous Cell Carcinoma in the External Auditory Canal Previously Treated for Verrucous Carcinoma

“…Verrucous carcinoma is a rare tumor of the head and neck, the most common sites being the oral cavity and larynx [45]. It very rarely involves the ear, and only 15 cases have been reported in the literature [791011].…”

“…The mass may infiltrate deeply with thickened squamous epithelium pushing borders but not invading the basement membrane [5]. A biopsy of such a lesion can be mistakenly classified as benign.…”

An individual drug-therapy and genetic testing report of temporal bone verrucous carcinoma

“…Based on a combination of the survey works of Strojan et al9 and Miller et al,10 all reported cases are summarized in Table 1.…”

Oral verrucous lesions: Controversies in diagnosis and management

“…Other sites reported in head and neck region include paranasal sinus, scalp, nasopharynx, oesophagus and temporal bone. 20,21 It is so uncommon that verrucous carcinoma composes only 5% of tumours at these sites. 21 In Greece, the reported incidence for VC among other intraoral malignancies is 5.8%.…”

“…20,21 It is so uncommon that verrucous carcinoma composes only 5% of tumours at these sites. 21 In Greece, the reported incidence for VC among other intraoral malignancies is 5.8%. 22 Although the mucous membranes of the head and neck are the most common sites of VC development, this tumour may also be found on other cutaneous surfaces including the anorectal region, external genitals and skin of the extremities, particularly the sole of the foot.…”