Verrucous Carcinoma

Verrucous carcinoma is a rare type of squamous cell carcinoma (cancer). Squamous cells are in many tissues of your body, including the lining of your mouth and throat, as well as the surface of your skin. 

Verrucous carcinoma (VER-uh-kuhs kahr-suh-NOH-muh) most often forms in the cells that line your cheeks, lips and the inside of your mouth. It may also form on your gums, tongue and the bone that holds your tooth sockets. It can form in your throat. Less often, people get verrucous carcinoma on their genitals or feet.

This cancer typically progresses slowly and rarely spreads. With treatment, the prognosis (outlook) is excellent. Surgery to remove the tumor cures it for most people. But the treatment you’ll need depends on your unique diagnosis.

Symptoms of verrucous carcinoma

Verrucous carcinoma often grows slowly. You might not notice symptoms for a while. As it progresses, you may see abnormal areas of tissue (lesions) in your mouth, on your genitals or on the soles of your feet.

Symptoms include:

• A sore, or reddish or white patches in your mouth
• A warty (cauliflower-like) mass in your mouth or on your genitals or feet
• Bad breath
• Pain at the site of the lesion (like your mouth, genitals or feet)
• Trouble chewing or swallowing

Verrucous carcinoma causes

Verrucous carcinoma develops when squamous cells grow in ways that aren’t normal. Doctors don’t know what exactly causes the abnormal growth. But they do know that exposure to cancer-causing substances (carcinogens) plays a role.

This cancer is most common in males, especially those in their 60s and 70s. You’re at a greater risk of developing it if you have a history of:

• Chewing betel nuts (areca palm seeds)
• Drinking alcohol or alcohol use disorder
• Poor oral hygiene
• Skin conditions, like lichen planus and lichen sclerosus
• Smoking (cigarettes, cigars or pipe tobacco) or using smokeless tobacco, like chewing tobacco or snuff

Verrucous carcinoma sometimes forms after an injury to your mouth or skin. Long-term inflammation in your skin or in the tissue lining your mouth can increase your risk.

How doctors diagnose this condition

Your healthcare provider will examine you and ask about your symptoms. They may suspect verrucous carcinoma if you have sores in your mouth, feet or genitals. They’ll likely ask about your medical history and whether you use tobacco.

You’ll need a biopsy before your provider can make a diagnosis. During this procedure, they’ll take a tissue sample and test it for cancer cells.

You may need more tests to see if the cancer has grown into surrounding tissue. Tests you may need include a:

• CT scan, to see if the cancer has grown into the bone
• MRI, to see if the cancer has grown into soft tissue

How is verrucous carcinoma treated?

Surgery is the most common treatment. Once healthcare providers remove the tumor, most people recover. Other treatment options include:

• Radiation therapy: You may need radiation if a tumor is so big that surgery would damage too much surrounding tissue. Your provider may suggest radiation after surgery to destroy any remaining cancer cells.
• Chemotherapy: You may get chemotherapy with or without radiation. Chemo can help relieve symptoms if the cancer is too advanced for surgery to help enough.

Some treatments may be an option if the tumor is only on your skin’s surface. They involve fewer side effects and shorter recovery times. Options include:

• Cryotherapy
• Photodynamic therapy
• Laser therapy

When should I see my healthcare provider?

Let your provider know if you find lesions in your mouth or on your genitals or feet that may be verrucous carcinoma.

This condition won’t go away on its own. Delaying treatment gives verrucous carcinoma a chance to spread or worsen. But early treatment often keeps this from happening.

What can I expect if I have verrucous carcinoma?

After treatment, many people fully recover and go on to live cancer-free lives. You may have scarring on your skin after surgery to remove lesions. You may need reconstructive surgery if your surgeon had to remove a lot of tissue or bone to get rid of all the cancer.

It’s possible for the cancer to grow back (recur). But overall, the prognosis (outlook) is excellent. The five-year survival rate for verrucous carcinoma is more than 75%. This means that more than 3 out of 4 people who get treatment are alive five years after they’re diagnosed.

Still, everyone’s situation is different. The size of the lesion or tumor makes a difference. Your general health factors in, too. Your healthcare provider will explain what to expect based on your unique case.

Can this be prevented?

You can reduce your risk of developing verrucous carcinoma by avoiding tobacco products. Try to quit smoking, vaping or using smokeless tobacco if you do. Drink alcohol only in moderation.

What is the difference between squamous cell carcinoma and verrucous carcinoma?

Verrucous carcinoma is just one type of squamous cell carcinoma. When verrucous carcinoma forms in your mouth, healthcare providers manage the condition as an oral cancer. When it develops on your genitals, they manage it as anal, penile or vulvar cancer. When it forms on your feet, they manage it as a skin cancer.