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Presented by Ralph Hruban, M.D. and prepared by Sharon Swierczynski, M.D., Ph.D.
Case 6: This elderly gentlemen presented with a long history of multiple exophytic skin lesions on his thumb.
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1. Question
Week 168: Case 6
This elderly gentlemen presented with a long history of multiple exophytic skin lesions on his thumb.images/010504case6fig1.jpg
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images/010504case6fig4.jpgCorrect
Answer: Verrucous carcinoma
Histology: These large exophytic epithelial lesions have a “church spire” pattern of growth, and a pushing infiltrative base.
Discussion: Most squamous cell carcinomas arise on sun-exposed skin. Verrucous carcinoma is a rare form of squamous carcinoma composed of well-differentiated cells. Verrucous carcinomas usually arise in the soles of the feet. They are related to HPV infection. While they are usually locally invasive, metastasis of a verrucous carcinoma is rare.
Incorrect
Answer: Verrucous carcinoma
Histology: These large exophytic epithelial lesions have a “church spire” pattern of growth, and a pushing infiltrative base.
Discussion: Most squamous cell carcinomas arise on sun-exposed skin. Verrucous carcinoma is a rare form of squamous carcinoma composed of well-differentiated cells. Verrucous carcinomas usually arise in the soles of the feet. They are related to HPV infection. While they are usually locally invasive, metastasis of a verrucous carcinoma is rare.
