By Gary M. White, MD
The verrucous carcinoma is a low-grade squamous cell carcinomas, common on the penis (Buschke-Lowenstein tumor), soles (carcinoma cuniculatum) and oral mucosa (oral florid papillomatosis).
A large cauliflower-like growth on the glans penis is characteristic of the Buschke-Lowenstein tumor. The patient is usually uncircumcised. The lesion may have been treated for years as a wart. HPV particles have been found in some cases (e.g. HPV 6), so indeed the precursor lesion may have been a wart.
It has been proposed that a continuum extends from condyloma to larger precancerous lesions to invasive SCC.
Standard excision or Mohs surgery is the treatment of choice. Other destructive modalities (e.g. cautery, cryotherapy) have been used. Radiation therapy should be avoided as recurrence and a more aggressive course has been reported.
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