To the Editor.—
The patient described by Seehafer et al1 is a unique and interesting case, but we would like to comment on the diagnosis.The term "verrucous carcinoma" (VC) was coined by Ackerman2 to describe a group of lesions with distinctive clinicopathologic features that were different from other forms of squamous cell carcinoma (SCC). One histologic feature, important for the diagnosis, is the absence of cellular atypia. Indeed, in the series3 cited by Seehafer et al, all 105 cases lacked cellular anaplasia. In the case in question here, the "marked nuclear atypia" noted is incompatible with the diagnosis of VC. The presence of anaplastic cells in a verrucous lesion indicates the diagnosis of SCC, regardless of how warty its surface may be.It should be noted also that the histologic picture of VC is not that of pseudoepitheliomatous hyperplasia. In VC, the fingers of epithelium are round and
Brodin MB, Mehregan AH. Verrucous Carcinoma. Arch Dermatol. 1980;116(9):987. doi:10.1001/archderm.1980.01640330025005
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