Overview

Verrucous carcinoma (VC) is a rare, slow-growing, well-differentiated type of squamous cell carcinoma (SCC) that is most frequently encountered in the oral cavity. It is a different kind of oral cancer compared to the typical Oral Squamous Cell Carcinoma. It typically grows outward as a thick, wart-like (Verrucous) mass and seldom metastasizes to lymph nodes or distant sites. Nevertheless, if left untreated, it may behave in a locally aggressive manner, invading nearby tissues and causing significant functional impairment.

It is more common in patients above 50 years of age and has strong associations with the chronic use of tobacco (smokeless tobacco being the commonest), paan, supari, and poor oral hygiene. The outlook is generally very good when it is detected early and treated with surgery.

What Is Verrucous Carcinoma?

Verrucous carcinoma is a low-grade, well-differentiated squamous cell carcinoma of the squamous epithelium of the lining of the mouth. It grows slowly and does not appear to spread rapidly through the body as other malignancies of the mouth do.

The tumor looks like a thick white cauliflower or a wart-like lump. The tumor frequently looks like benign lesions of the mouth and is difficult to diagnose in the early stages. The diagnosis is verified only by histological study of a biopsy.

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Verrucous Carcinoma most commonly arises in the:

• Inside of cheek (buccal mucosa)
• Gums (gingiva)
• Alveolar ridge
• Language
• Floor of mouth
• Firm mouth
• Labios

The buccal mucosa is the most common site of involvement, especially in people who habitually insert chewing tobacco or betel quid in that area.

What are the Causes & Risk Factors of Verrucous Carcinoma?

Verrucous Carcinoma has extremely few risk factors.

Use of Tobacco

The biggest danger comes from using it over the long term:

• Smokeless Tobacco
• Gutkha
• Khaini or tobacco paste
• Pan Masala Cigarettes
• Bidis

Betel Quid with Areca Nut

Repeated chewing of betel quid and areca nut can cause continuous inflammation of the lining of the mouth, dramatically increasing the risk of cancer.

Drinking Alcohol

The risk of heavy alcohol use (particularly combined with smoking) may be increased.

Mouth, chronic irritation

Long-term inflammation of oral tissues can be induced by ill-fitting dentures, shattered teeth, and chronic trauma.

Poor Oral Hygiene

The lack of appropriate oral hygiene and untreated dental infection may enhance the risk.

Human papillomavirus (HPV)

In some circumstances, HPV strains have been implicated, however, less strongly than usual squamous cell carcinoma.

What are the Signs & Symptoms of Verrucous Carcinoma ?

Verrucous Carcinoma usually grows slowly over months or years.

Typical symptoms include:

• White spot on the tongue, thick
• Wart or cauliflower-like growth
• Chronic mouth ulcer
• Smooth oral swelling
• Difficulty chewing
• Trouble swallowing
• Foul odor
• Trauma-related bleeding
• Loose teeth in late disease
• Hard to wear dentures
• Jaw pain

Pain is often only a late-stage phenomenon.

Clinical Features

The lesion most often presents as:

• White or grayish-white
• Thickened
• Uneven ground
• All inclusive
• Slow growth rate
• Exophytic (outward growth)
• Cauliflower-shaped or warty

It can simulate benign lesions such as oral papilloma or persistent hyperkeratosis.

How is Verrucous Carcinoma Diagnosed?

Accurate diagnosis needs both clinical evaluation and laboratory inquiry.

Physical Exam

The oral cavity and neck are examined thoroughly for size, location, and regional lymph node involvement of the lesion.

Biopsy

Superficial samples are not always accurate in detecting the tumor, so a deep incisional biopsy is needed.

Histopathology frequently demonstrates:

• Well-differentiated squamous epithelium
• Lack of cellular atypia
• “Pushing” margins are not finger-like projections.
• Hyperkeratosis
• Papilla surface architecture

Imaging Studies

Depending on tumor size, imaging may include:

• Computed Tomography Scan
• MRI
• Ultrasound
• PET-CT (Selected Cases)

These studies grade the degree of local invasion.

What are the Treatment Methods for Verrucous Carcinoma ?

Treatment depends on the size and position of the tumor and the patient's general health.

Operation

The treatment of choice with the highest cure rates is complete surgical excision with appropriate margins.

The purpose of surgery is to retain speech, swallowing, and attractiveness wherever feasible.

Neck Dissection

Lymph node metastases are uncommon. Routine neck dissection is generally not warranted. It can be suspected to be lymph node involvement or conventional squamous cell cancer.

Radiation Therapy

Radiation therapy is often reserved for selected individuals who are not surgical candidates or who have recurrent disease. Surgery remains the best treatment for most instances.

After the visit

Because recurrence may occur, long-term follow-up is required, especially in the face of continuing risk factors such as tobacco smoking.

Patients should receive regular oral examinations, and any new lesions should be reported immediately.

What ia Prognosis Verrucous Carcinoma ?

Verrucous carcinoma is usually associated with an excellent prognosis if diagnosed early and completely removed.

Prognostic factors:

• Diagnosis in the early stage
• Radical excision
• Tobacco cessation
• Regular follow-up

Untreated lesions can cause local destruction and may, in some cases, progress to typical squamous cell carcinoma. Distant metastasis is rare.

How to Prevent us from Verrucous Carcinoma ?

You can minimize your chances of developing Verrucous Carcinoma by:

• Tobacco in any kind
• Do not chew betel quid and areca nut.
• Limit alcohol
• Practice good oral hygiene.
• Attending regular dental check-ups
• Evaluations of chronic oral lesions
• Constant annoyance of broken teeth or badly fitted dentures.

When to Seek Medical Help ?

See a health care provider if you:

• White or thickened patch lasting longer than two weeks.
• An ugly, warty growth in the mouth
• Nonhealing ulcer
• Difficulty chewing or swallowing
• Constantly puffy mouth
• Spontaneous bleeding from the mouth

Getting treatment earlier leads to better results and reduces the risk of complications.

Why choose Tender Palm Super-Speciality Hospital for Verrucous Carcinoma Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Verrucous Carcinoma treatment in Lucknow, India, at an affordable cost. We have a team of experienced oral and maxillofacial surgeons and oncology specialists who provide accurate diagnosis and both non-surgical and surgical treatment options including tumor resection, radiation therapy, and comprehensive oncological management procedures. Our Oral and Maxillofacial Surgery and Oncology team has decades of experience in successfully treating Verrucous Carcinoma in Lucknow, India.

To seek an Expert consultation for Verrucous Carcinoma Treatment in Lucknow ,India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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