Trøstrup Hannah, Matzen Steen H
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Int J Surg Case Rep. 2019;54:7-9. doi: 10.1016/j.ijscr.2018.11.017. Epub 2018 Nov 27.
Verrucous carcinoma is an uncommon variant of low-grade squamous cell malignancy with a low malignant potential but a high risk of recurrence.
We report a case of a Human Papilloma Virus negative local verrucous carcinoma in the perianal area of a 45-year old otherwise healthy female. The tumor presented clinically as a persistent genital wart not responding to usual dermatologic local therapy. The patient was referred to the Department of Plastic Surgery and Breast Surgery after primary excision in a private practice setting of a general surgeon. Three months later, further excision revealed local lichen sclerosus inflammatory changes in close proximity to the excision scar.
Due to the low occurrence of verrucous carcinoma in the perianal area, no guidelines are available for the management of this disease. Conflicting reports on the ethiology and the nomenclature and classifications of verrucous carcinomas exist.
Avoid pitfalls in the diagnosis of a rare variant of squamous cell cancer with a high recurrence ratio: Common genital warts not responding to ordinary local antimitotic Podophyllotoxin treatment require biopsy to exclude verrucous carcinoma. Follow-up is recommended at a 3-6 months interval due to the relative high risk of relapse.
疣状癌是一种罕见的低级别鳞状细胞恶性肿瘤变体，恶性潜能低但复发风险高。
我们报告一例45岁健康女性肛周区域的人乳头瘤病毒阴性局部疣状癌。该肿瘤临床上表现为持续性生殖器疣，对常规皮肤科局部治疗无反应。在一名普通外科医生的私人诊所进行初次切除后，患者被转诊至整形外科和乳腺外科。三个月后，进一步切除显示切除瘢痕附近存在局部硬化性苔藓样炎性改变。
由于肛周区域疣状癌发生率低，尚无针对该疾病管理的指南。关于疣状癌的病因、命名和分类存在相互矛盾的报道。
避免在诊断具有高复发率的罕见鳞状细胞癌变体时出现失误：对普通局部抗有丝分裂鬼臼毒素治疗无反应的常见生殖器疣需要活检以排除疣状癌。鉴于相对较高的复发风险，建议每3至6个月进行一次随访。
