PLANTAR VERRUCOUS CARCINOMA FOLLOWING TRANSMETATARSAL AMPUTATION AND RENAL-TRANSPLANTATION

Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell carcinoma that may occur anywhere on the skin. It is slow growin g, enlarges relentlessly, and invades locally. Most cutaneous verrucou s carcinomas are found on the plantar surface of the foot, and share m any gross and histological characteristics common to the ubiquitous ve rruca vulgaris. It is not uncommon for verrucous carcinoma of the sole to be mistaken for the more common verruca plantaris. The case of a 5 3-year-old white male with plantar verrucous carcinoma following cadav eric renal transplantation, right popliteal-tibial bypass, and a right transmetatarsal amputation is presented. Treatment included reamputat ion followed by reconstruction with a free radial forearm fasciocutane ous flap. Verrucous carcinoma is a slow-growing but relentlessly invad ing tumor that is easily misdiagnosed. The extent of early resection i s often inadequate. We must be aware that certain persistent ''warts'' may represent a form of cancer that is treated differently from commo n verrucae or other squamous carcinomas.