Microscopic examination of the biopsy specimen showed epidermal acanthosis with blunt epidermal projections extending into the dermis. Koilocytes were present. Excision to subcutaneous tissue was performed with negative intraoperative margins by frozen as well as permanent sections. A split-thickness skin graft was used to cover the wound. There has been no recurrence at 4 years.
The term verrucous carcinoma was coined in 19481 to define a well-differentiated, slow-growing neoplasm with a tendency for local recurrence, but without a tendency to metastasize. Verrucous carcinoma was first described in the oral cavity. Subsequently, it has been reported in other stratified squamous surfaces, including mucous, mucocutaneous, and cutaneous sites. The 3 major locations of verrucous carcinoma are the oral cavity (oral florid papillomatosis), the anogenital region (giant condyloma of Buschke and Lowenstein), and the plantar surface of the foot (epithelioma cuniculatum).
An Ulcerating Verrucous Plaque on the Foot. Arch Dermatol. 2000;136(4):547-552. doi: