An 80-year-old Japanese man was evaluated for an asymptomatic, firm, rapidly growing tumor on his lower lip of about 3 months' duration. Findings from the physical examination showed a nontender, irregularly elevated keratotic lesion involving the left half of the lower lip and measuring 2.5 cm in length and 1.3 cm in width, with a moderate amount of induration in the center of the lesion (Fig 1). Slightly elevated whitish patches were noted around the keratotic lesion. Cervical adenopathy was not noted.
Histologic sections from the lesion showed marked hyperkeratosis, focal parakeratosis, and massive irregular acanthosis. The downward extension of the epithelium penetrated deeply into the underlying connective tissue. Keratin-filled crypts and cysts, often admixed with polymorphonuclear leukocytes, were seen. Nuclear atypia was absent in the deep portions of the tumor. A pronounced mixed inflammatory response was noted within the dermis.
Verrucous carcinoma of the lower lip.
Surgical excision is the preferred method in most cases for verrucous carcinoma, and the cure rate with this tech