The Ohio State University College of Medicine, Columbus, OH, USA.
Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Arch Dermatol Res. 2023 Mar;315(2):133-137. doi: 10.1007/s00403-022-02396-2. Epub 2022 Sep 16.
Verrucous carcinoma is a rare, low grade variant of squamous cell carcinoma that rarely metastasizes but tends to display aggressive local behavior. Wide local excision is the most common treatment, but has high rates of local recurrence, ranging from 19 to 75% in the literature. The cases of verrucous carcinoma treated with Mohs micrographic surgery in the literature, as well as a previously unpublished case is summarized. PubMed was searched for terms related to verrucous carcinoma and Mohs micrographic surgery, and articles reporting cases of verrucous carcinoma treated with Mohs were reviewed and summarized. A previously unpublished case treated at our institution was also reported. Thirty-eight cases of verrucous carcinoma treated with Mohs surgery were analyzed. The average age of patients was 52.1, and 50% were male. The most common sites were the foot (47%) and the anogenital region (34%). Lesion duration ranged from 0.17 to 40 years with a mean of 4.8 years, and tumor diameter ranged from 1 to 10 cm with a mean of 4.6 cm. The local recurrence rate following Mohs was 16%, with nodal metastasis occurring in 3% and no cases of distant metastasis. As verrucous carcinoma demonstrates locally aggressive behavior and a high risk of local recurrence, Mohs micrographic surgery should be considered as first line treatment. Further research directly comparing wide local excision to Mohs surgery is needed.
疣状癌是一种罕见的低级别鳞状细胞癌变体，很少转移，但往往表现出侵袭性的局部行为。广泛局部切除是最常见的治疗方法，但局部复发率很高，文献报道的复发率为 19%至 75%。总结了文献中报道的经Mohs 显微外科手术治疗的疣状癌病例，以及一个以前未发表的病例。在 PubMed 上搜索与疣状癌和 Mohs 显微外科手术相关的术语，并回顾和总结了报道经 Mohs 治疗的疣状癌病例的文章。还报告了我们机构治疗的一个以前未发表的病例。分析了 38 例经 Mohs 手术治疗的疣状癌病例。患者的平均年龄为 52.1 岁，50%为男性。最常见的部位是脚（47%）和肛门生殖器区域（34%）。病变持续时间从 0.17 年到 40 年不等，平均为 4.8 年，肿瘤直径从 1 厘米到 10 厘米不等，平均为 4.6 厘米。Mohs 手术后的局部复发率为 16%，淋巴结转移率为 3%，无远处转移病例。由于疣状癌表现出局部侵袭性行为和高局部复发风险，Mohs 显微外科手术应被视为一线治疗方法。需要进一步研究直接比较广泛局部切除与 Mohs 手术的效果。
