Carcinoma cuniculatum C44.L5

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

epithelioma cuniculatum; verrucous carcinoma

History
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Ackerman, 1948; Aird, 1954

Definition
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Variant of the spinocellular carcinoma defined by the particular localization (inguinal skin), with a low degree of malignancy. S.a. Carcinoma verrucosum.

Occurrence/Epidemiology
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Mostly in men. clustered in the 50th-70th LJ.

Localization
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On the feet, mostly in the area of the metatarsal head I, on the toes, medioplantar, on the heel. Also described on the perineum.

Clinical features
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Frequently endophytically (pressure-induced) growing, verrucous, even superficially ulcerating, painful tumor, which is pervaded by deep fistuous crypts and filled with macerated keratin masses. Fetus. No metastatic tendency!

Histology
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Mature squamous cell carcinoma with a strong cornification tendency. Strikingly high degree of maturation, extensive absence of nuclear atypia, dyskeratotic cells and low number of mitoses.

Differential diagnosis
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Therapy
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According to the carcinoma verrucosum. Excision with micrographic preparation of the excidate, safe absence of tumor must be guaranteed. The danger of recurrence is high! No radiotherapy, as the tumour is not very sensitive to radiation (danger of radiation ulcer).

Progression/forecast
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Favourable, with adequate surgical procedure.

Note(s)
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The term "Carcinoma cuniculatum" is increasingly losing its meaning after florid oral papillomatosis together with florid oral papillomatosis, papillomatosis cutis carcinoides and condylomata gigantea were combined to form the term "verrucous carcinoma of the skin/mucosa". In the literature the terms are partly used synonymously, partly also separately listed (histological differentiation between carcinoma cuniculatum and verrucous carcinoma is possible). In the dermatological literature the carcinoma cuniculatum is mainly associated with the infestation of the inguinal skin (sole of the foot) in relation to the location.

Literature
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  1. Ackerman LV (1948) Verrucous carcinoma of oral cavity. Surgery 23: 670-678
  2. Aird J et al (1954) Epithelioma cuniculatum: a variety of squamos carcinoma peculiar to the foot. Br J Surg 42: 245-250
  3. Heinzerling LM et al (2003) treatment of verrucous carcinoma with imiquimod and CO2 laser ablation. Dermatology 207: 119-122
  4. Ho J et al (2000) An ulcerating verrucous plaque on the foot. Verrucous carcinoma (epithelioma cuniculatum). Arch Dermatol 136: 547-548, 550-551
  5. Cubic MJ et al (2012) Carcinoma cuniculatum: not a verrucous carcinoma. J Cutan catholic 39:1083-1087

  6. Mehta RK et al (2000) Treatment of verrucous carcinoma of vulva with acitretin. Br J Dermatol 142: 1195-1198
  7. Patel AN et al (2013) Pain-free treatment of carcinoma cuniculatum on the heel using Mohs micrographic surgery and ultrasonography-guided sciatic nerve block. Clin Exp Dermatol 38:569-571
  8. Already MP et al (2000) Presternal verrucous carcinoma.dermatologist 51: 766-769
  9. Tauber M et al (2014) Unresectable perineal cuniculatum carcinoma: partial remission using systemic isotretinoin and interferon-α2a therapy. Acta Derm Venereol 94:721-722

  10. Thomas EJ et al (2014) Carcinoma cuniculatum: an atypical presentation in the foot. J Foot Ankle Surgery 53:356-359

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Last updated on: 29.10.2020