Verrucous Carcinoma

Overview

Verrucous carcinoma is a rare, slow-growing, well-differentiated type of squamous cell carcinoma that commonly affects the mouth, throat, voice box, genital region, and skin. It usually appears as a thick, wart-like growth and tends to grow locally rather than spread rapidly to other parts of the body. Although it is considered a low-grade cancer, delayed diagnosis can lead to significant local tissue destruction and functional problems.

Early diagnosis and timely Verrucous Carcinoma Treatment are essential for achieving the best outcomes. Treatment often involves surgery, while selected patients may require additional therapies depending on the tumour's location and extent.

At Sarvodaya Hospital, our experienced surgical oncologists, head and neck cancer specialists, dermatologists, and multidisciplinary oncology team provide comprehensive oncology treatment using advanced diagnostics and personalised cancer care.

Symptoms of Verrucous Carcinoma

• Thick wart-like growth
• White or grey patches inside the mouth
• Persistent mouth ulcer
• Slow-growing skin lesion
• Difficulty chewing or swallowing
• Hoarseness of voice
• Bleeding from the affected area
• Pain or discomfort
• Bad breath in oral lesions
• Non-healing growth

Causes of Verrucous Carcinoma

• Tobacco chewing
• Smoking
• Alcohol consumption
• Human papillomavirus (HPV) infection in selected cases
• Chronic irritation
• Poor oral hygiene
• Long-standing inflammatory lesions
• Sun exposure for skin lesions

Common Sites of Verrucous Carcinoma

Verrucous carcinoma can develop in different parts of the body.

• Oral Cavity: The cheeks, gums, tongue, and inner lining of the mouth are the most commonly affected sites.
• Larynx (Voice Box): Tumours may develop in the voice box, causing persistent hoarseness.
• Skin: Skin lesions often appear as slowly enlarging wart-like growths on exposed or chronically irritated areas.
• Genital Region: Rarely, verrucous carcinoma may affect the genital or anal region.

Risk Factors for Verrucous Carcinoma

Several lifestyle and medical factors increase the risk of developing this cancer.

• Tobacco Use: Smoking and chewing tobacco are the strongest risk factors, particularly for oral verrucous carcinoma.
• Alcohol Consumption: Heavy alcohol intake further increases the risk when combined with tobacco use.
• Poor Oral Hygiene: Long-standing oral irritation and poor dental health may contribute to tumour development.
• Chronic Irritation: Persistent irritation from ill-fitting dentures or chronic inflammation may increase the risk.
• Human Papillomavirus (HPV): Some cases have been associated with HPV infection, although this varies depending on tumour location.

Diagnosis of Verrucous Carcinoma

Early diagnosis helps determine the tumour extent and guides the most appropriate treatment.

• Clinical Examination: Doctors assess the appearance, size, location, and extent of the lesion along with associated symptoms.
• Biopsy: A tissue biopsy is essential to confirm the diagnosis and distinguish verrucous carcinoma from other oral or skin lesions.
• CT Scan: CT imaging evaluates local tumour extension and involvement of surrounding structures.
• MRI Scan: MRI provides a detailed assessment of soft tissue involvement, particularly in head and neck cancers.
• PET-CT Scan: PET-CT may be recommended in selected patients to evaluate advanced disease and treatment planning.
• Endoscopy: For lesions involving the throat or voice box, endoscopic examination helps assess tumour extent.

Treatment Options & Technology for Verrucous Carcinoma

Verrucous carcinoma treatment focuses on complete tumour removal while preserving normal function and reducing recurrence.

• Cancer Surgery: Complete surgical removal is the primary treatment and offers excellent outcomes for most patients.
• Reconstructive Surgery: Where required, reconstructive procedures help restore appearance and function following tumour removal.
• Radiation Therapy: Radiotherapy may be recommended in selected patients when surgery is not suitable or additional treatment is required.
• Comprehensive Oncology Care: A multidisciplinary team develops an individualised treatment plan based on tumour location, stage, and overall health.
• Regular Follow-up Monitoring: Long-term surveillance helps detect recurrence early and supports successful carcinoma management.
• Advanced Oncology Technology: High-Resolution MRI, CT Scan, PET-CT, Image-Guided Biopsy, Endoscopy, Robotic Surgery (where appropriate), and Precision Radiation Therapy support accurate diagnosis and advanced oral cancer treatment.

Benefits of Early Verrucous Carcinoma Treatment

Early diagnosis significantly improves treatment outcomes and long-term survival.

• Improves Surgical Success: Small tumours can often be removed completely with excellent results.
• Preserves Normal Function: Early treatment helps maintain speech, swallowing, and appearance.
• Reduces Local Tissue Damage: Prompt intervention prevents extensive local tumour growth.
• Lowers Recurrence Risk: Complete tumour removal reduces the chance of recurrence.
• Enhances Quality of Life: Timely treatment supports faster recovery and better long-term outcomes.

Complications if Left Untreated

Untreated verrucous carcinoma may lead to progressive local damage.

• Extensive tissue destruction
• Difficulty eating or swallowing
• Speech difficulties
• Persistent bleeding
• Secondary infections
• Cosmetic deformity
• Rare progression to more aggressive cancer

When Should You See a Doctor?

Consult an oncologist or specialist if you notice:

• A persistent wart-like growth
• A non-healing mouth ulcer
• White patches inside the mouth
• Persistent hoarseness
• Difficulty swallowing
• Unexplained oral bleeding
• Any growth lasting more than two weeks

Prevention & Lifestyle Modifications

Healthy lifestyle choices help reduce the risk of verrucous carcinoma.

• Avoid Tobacco Products: Stopping smoking and tobacco chewing significantly lowers the risk of oral cancers.
• Limit Alcohol Consumption: Reducing alcohol intake helps decrease cancer risk.
• Maintain Good Oral Hygiene: Regular dental care and oral hygiene help prevent chronic irritation.
• Protect Skin from Sun Exposure: Use protective clothing and sunscreen for exposed skin.
• Attend Regular Oral Examinations: Routine dental and medical check-ups help detect suspicious lesions early.

Pre–Post Treatment Care

Pre-Treatment

• Oncology consultation
• Biopsy confirmation
• CT, MRI, or PET-CT imaging
• Treatment planning by a multidisciplinary team

Post-Treatment

• Regular oncology follow-up
• Wound care and rehabilitation
• Nutritional support if required
• Speech and swallowing therapy when indicated
• Long-term surveillance for recurrence