Terada Tadashi
Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231, Shimizu-Ku, Shizuoka 424-8636 Japan.
J Maxillofac Oral Surg. 2011 Jun;10(2):148-51. doi: 10.1007/s12663-011-0197-x. Epub 2011 Apr 20.
To reports ten Japanese surgical cases of verrucous carcinoma (VC) of the oral cavity.
The author reviewed histopathology of 10 cases of oral VC.
Ten cases of oral VC were found in our pathology department in the last 10 years. During the 10 years, a total of 187 cases of oral malignancy were recognized. Therefore, the frequency of VC was 5.3% of all oral malignancies. The patients consisted of six women and four men. The age ranged from 52 to 84 years with a median of 68 years. The locations of VC were buccal mucosa in two cases, gingiva in three cases, hard palate in one case, tongue in three cases, and soft palate in one case. The presenting symptoms were oral discomfort in two cases and tumors in eight cases. All cases underwent surgical resection. Frozen sections were performed in three cases for margin check. Grossly, all cases showed verrucous lesions. The size ranged from 0.8 to 3.2 cm with a median of 1.3 cm. Histologically, tumor cells proliferated with verrucous or papillary features. The tumor cells had acidophilic, ample cytoplasm, and nuclear atypia was minimal. Individual keratinization, koilocytosis, basal cell mild atypia, and squamous pearl formation were recognized in all cases. Three cases showed microinvasion. One case had focal ordinary squamous cell carcinoma within the VC. Epithelial dysplasia in the mucosa was recognized in the vicinity of VC in two cases. One case showed multiple tumors of VC; the number was five. Lymphocytic infiltration in the dermis was recognized in seven cases. Immunohistochemically, p53 protein was positive in all the ten cases. Its location was accentuated near the basal cells and microinvasive parts. Ki-67 positive cells were also seen mainly in the basal cells and in the microinvasive areas, and the KI-67 labeling index ranged from 12 to 21%. Two patients recurred, and additional operations were performed. None show metastatic lesions. One patient died of other disease, and nine patients are now alive without tumors.
Clinicopathologic features of ten cases of oral VC were described.
报告10例日本口腔疣状癌（VC）的手术病例。
作者回顾了10例口腔VC的组织病理学。
在过去10年中，我们病理科共发现10例口腔VC。在这10年期间，共确诊187例口腔恶性肿瘤。因此，VC在所有口腔恶性肿瘤中的发生率为5.3%。患者包括6名女性和4名男性。年龄范围为52至84岁，中位年龄为68岁。VC的发病部位：颊黏膜2例，牙龈3例，硬腭1例，舌3例，软腭1例。临床表现为2例口腔不适，8例肿瘤。所有病例均接受手术切除。3例行冰冻切片检查切缘。大体上，所有病例均表现为疣状病变。大小范围为0.8至3.2 cm，中位大小为1.3 cm。组织学上，肿瘤细胞呈疣状或乳头状增生。肿瘤细胞嗜酸，胞质丰富，核异型性极小。所有病例均可见个别角化、空泡细胞形成、基底细胞轻度异型性及鳞状上皮珠形成。3例有微浸润。1例在VC内有局灶性普通鳞状细胞癌。2例在VC附近的黏膜中发现上皮发育异常。1例有5个VC多发肿瘤。7例真皮内有淋巴细胞浸润。免疫组化显示，10例p53蛋白均为阳性。其定位在基底细胞和微浸润部位附近增强。Ki-67阳性细胞也主要见于基底细胞和微浸润区域，Ki-67标记指数为12%至21%。2例复发，再次手术。均无转移灶。1例死于其他疾病，9例目前无瘤存活。
描述了10例口腔VC的临床病理特征。
