VERRUCOUS CARCINOMA - NOSOLOGICAL POSITIO N - ABOUT 4 CASES

Introduction. The nosology of verrucous carcinomas is a complicated pr oblem. The name given to each manifestation may vary with localization . We report our findings in four cases with this skin disease. Case re ports. Four patients, 76, 52, 76 and 55 years of age, presented with v errucous carcinoma. In the first case, the disease began with a chroni c varicose ulceration localized on the anterolateral aspect of the rig ht leg. In the second, the lesion was localized on the lateral aspect of the right leg facing a zone showing signs of repeated microtraumati sms. HPV-18 was isolated in this patient. The third case had a vegetat ing lesion on the dorsal aspect of the right hand, simulating a wart. The fourth case is a historic case in which a voluminous tumour develo ped over several years on an ulceration of the medial aspect of the le ft malleole, associated with trauma and venous insufficiency. Comments . The three recent cases did not raise any particular problem with dia gnosis. The diagnosis in the historical case, published in 1969 as a v egetating pyoderma, was corrected later. This illustrates the nosology problems raised in this particular form of epidermoid carcinoma which often has an impressive clinical presentation and a reassuring histol ogy. The group of verrucous carcinomas include different skin or mucos al lesions formerly designated as oral florid papillomatosis, Buschke- Lowenstein acuminate condyloma or pseudo-epitheliomatous vegetating py oderma. Cuniculatum epithelioma was added to this group for simplifica tion although this rarely observed lesion is a separate entity. Conclu sion. The pathology diagnosis of verrucous carcinoma requires large an d deep biopsy. Treatment is surgical and regular follow-up is needed a s for all malignant rumours.