Verrucous carcinoma of larynx

Verrucous carcinoma is a well-differentiated variant of squamous cell carcinoma that lacks metastatic property.  The lesion shows marked surface keratinization arranged in “church-spire” configuration with bulbous rete pegs pushing into the stroma.  No dysplastic features are found.

Verrucous carcinoma (VC) typically occurs in men in their sixth and seventh decade. Etiology include tobacco smoking and HPV 16 and 18 infection. Oral cavity is the most common site of the lesion (15-35%), followed by the larynx (1-4%). Patients with laryngeal VC present with hoarseness associated with dysphagia, hemoptysis and airway obstruction. With oral VC, patients complain of warty-like mass associated with or without pain. Surgical resection is the treatment of choice. Radiotherapy can be utilized in advanced stage disease or in patients who are poor surgical candidates.