Synonym(s)
Ackerman tumor; carcinoma verrucosum; cutaneous verrucous carcinoma; mucosal verrucous carcinoma; verrucous carcinoma; Verrucous carcinoma; verrucous carcinoma of the mucosa; verrucous carcinoma of the skin
HistoryThis section has been translated automatically.
Lauren Vedder Ackerman, 1948
DefinitionThis section has been translated automatically.
Name for a group of low-malignant, slowly exophytic, wart-like growing, highly differentiated spinocellular carcinomas with only a very low tendency to metastasize. The tumours originally described by Ackerman were all localised in the oral cavity(florid oral papillomatosis).
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ClassificationThis section has been translated automatically.
The following clinical pictures are regarded as variants of carcinoma verrucosum, which differ in their localization but show a comparable histological pattern and biological growth behavior:
- Papillomatosis cutis carcinoides (= carcinoma verrucosum of the skin)
- Florid oral papillomatosis (= carcinoma verrucosum of the oral cavity)
- Condylomata gigantea (= carcinoma verrucosum of the genital region; Buschke-Löwenstein tumor)
- Carcinoma cuniculatum (= carcinoma verrucosum of the sole of the foot/toes)
Other localizations are also possible, but less common (e.g. back, face, acral finger region, lower leg on the base of a chronic ulcus cruris).
EtiopathogenesisThis section has been translated automatically.
A causation of genital manifestations by HPV 16 is discussed.
Oral manifestations are favored by previous inflammatory diseases of the oral mucosa (e.g. lichen planus mucosae) and chronic "irritants", especially:
- Chewing tobacco consumption
- betel nut chewing ( oral submucous fibrosis)
- Kath chewing (Somalia and Yemen).
In tropical countries, the occurrence in combination with schistosomiasis has often been described.
HistologyThis section has been translated automatically.
Exophytic and endophytic growing epithelial tumor with pronounced acanthosis and papillomatosis. The surface is overlaid by ortho- and parakeratotic horn material. In the tumor parenchyma itself, duct-like or cystic structures filled with horn are visible, sometimes also filled with cell debris. The epithelium in the upper part of the tumor consists of well differentiated keratinocytes with preserved stratification and only a few mitoses. At the base of the tumour, clumsy epithelial strands of increasingly polymorphic keratinocytes are visible. Dyskeratoses and mitoses are also present. Displacement of the local connective tissue as a sign of invasiveness. Occasionally, solitary epithelial islands are also found in the middle of the local connective tissue. Moderate perilesional lymphocytic infiltrate. The histological picture is decisively influenced by the tumor localization (in case of localization at the sole of the foot, exophytic growth recedes into the background).
TherapyThis section has been translated automatically.
See below for the respective specificities Papillomatosis, florid oral; see below Condylomata gigantea.
Progression/forecastThis section has been translated automatically.
Tendency to recur in loco, rarely lymphogenic metastasis.
Note(s)This section has been translated automatically.
For the histological evaluation of this carcinoma variant, an artificially unaltered excision biopsy of sufficient depth and width (the base of the tumor must be adequately recorded) is necessary to assess the necessary differential diagnostic criteria for assessing dignity (exo- and endophytic growth, invasiveness, cytomorphology), especially in the area of the tumor base.
LiteratureThis section has been translated automatically.
- Ackerman LV (1948) Verrucous carcinoma of oral cavity. Surgery 23: 670-678
- Heinzerling LM et al. (2003) treatment of verrucous carcinoma with imiquimod and CO2 laser ablation. Dermatology 207: 119-122
- Ho J et al. (2000) An ulcerating verrucous plaque on the foot. Verrucous carcinoma (epithelioma cuniculatum). Arch Dermatol 136: 547-548, 550-551
- Lu S et al. (2000) Anal verrucous carcinoma and penile condylomata acuminata. Dermatology 200: 320-323
- Matoso A et al (2012) Verrucous carcinoma of the nail unit. Am J
- Dermatopathol 34:e106-110
- Mehta RK et al. (2000) Treatment of verrucous carcinoma of vulva with acitretin. Br J Dermatol 142: 1195-1198
- Pleat J et al (2001) Cutaneous verrucous carcinoma. Br J Plast Surg 54: 554-555
- Schon MP et al (2000) Presternal verrucous carcinoma. Dermatology 51: 766-769
- Schwartz RA (1995) Verrucous carcinoma of the skin and mucosa. J Am Acad Dermatol 32: 1-21
- Terada T (2011) Verrucous carcinoma of the skin: a report on 5 Japanese cases. Ann
- Diagn Pathol 15:175-180
- Vorbeck J et al. (2022) Fast-growing skin lesion on the lower leg. J Dtsch Dermatol Ges 20:1524-1526.
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Incoming links (15)
Ackerman, lauren-vedder; Ackerman tumor; Betel nut; Betel nut; Betel nut; Carcinoma verrucosum; Catha edulis; Gigantean condyloma; Lichen simplex chronicus verrucosus; Microscopically controlled surgery; ... Show allOutgoing links (10)
Betel nut; Bilharzia; Carcinoma cuniculatum; Catha edulis; Fibrosis oral submucous; Gigantean condyloma; Oral Lichen planus ; Papillomatosis cutis carcinoides; Papillomatosis floride oral; Squamous cell carcinoma of the skin;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer
