Abstract
Verrucous carcinoma (VC) is an uncommon, low-grade variant of squamous cell carcinoma. Its benign histologic appearance and indolent course may lead to a delayed diagnosis. We report a rare case of an inverted verrucous carcinoma of the buttock presenting as a slow-growing subcutaneous lesion with a draining sinus and no exophytic component, clinically mimicking abscess and gossypiboma, with magnetic resonance imaging (MRI) and pathologic correlation. Biopsy of the lesional base is mandatory for accurate diagnosis. An enhancement pattern with a convoluted undulating appearance in a subcutaneous lesion displayed on MRI should raise a consideration of inverted VC in the differential diagnosis.
References
Cruickshank AH, McConnell EM, Miller DG. Malignancy in scars, chronic ulcers, and sinuses. J Clin Pathol. 1963;16:573–80.
Smith J, Mello LF, Nogueira Neto NC, Meohas W, Pinto LW, Campos VA, et al. Malignancy in chronic ulcers and scars of the leg (Marjolin’s ulcer): a study of 21 patients. Skelet Radiol. 2001;30(6):331–7.
Meaume S, Fromantin I, Teot L. Neoplastic wounds and degenerescence. J Tissue Viability. 2013;22(4):122–30.
Kraus FT, Perezmesa C. Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer. 1966;19(1):26–38.
Becker M, Moulin G, Kurt AM, Zbären P, Dulgerov P, Marchal F, et al. Atypical squamous cell carcinoma of the larynx and hypopharynx: radiologic features and pathologic correlation. Eur Radiol. 1998;8(9):1541–51.
Ferlito A, Recher G. Ackerman’s tumor (verrucous carcinoma) of the larynx: a clinicopathologic study of 77 cases. Cancer. 1980;46(7):1617–30.
Ackerman LV. Verrucous carcinoma of the oral cavity. Surgery. 1948;23(4):670–8.
Aird I, Johnson HD, Lennox B, et al. Epithelioma cuniculatum, a variety of squamous carcinoma peculiar to the foot. Br J Surg. 1954;42:245–50.
Anscombe AM, Isaacson P. An unusual variant of squamous cell carcinoma (inverted verrucous carcinoma) arising in a pilonidal sinus. Histopathology. 1983;7(1):123–7.
Theodorou SJ, Theodorou DJ, Bona SJ, Farooki S. Primary squamous cell carcinoma: an incidental toe mass. AJR Am J Roentgenol. 2005;184(3 Suppl):S110–1.
Barnhill RL. Tumors of the epidermis. In: Barnhill RL, editor. Textbook of dermatopathology. New York: McGraw Hill; 1998. p. 521–5.
Arefi M, Philipone E, Caprioli R, Haight J, Richardson H, Sheng C. A case of verrucous carcinoma (epithelioma cuniculatum) of the heel mimicking infected epidermal cyst and gout. Foot Ankle Spec. 2008;1(5):297–9.
Melo CR, Melo IS. Carcinoma cuniculatum of the buttock. An unusual case with an inverted growth. Dermatologica. 1989;179(1):38–41.
Yip KM, Lin-Yip J, Kumta S, Leung PC. Subcutaneous (“inverted”) verrucous carcinoma with bone invasion. Am J Dermatopathol. 1997;19(1):83–6.
Kao GF, Graham JH, Helwig EB. Carcinoma cuniculatum (verrucous carcinoma of the skin): a clinicopathologic study of 46 cases with ultrastructural observations. Cancer. 1982;49(11):2395–403.
Wasserman PL, Taylor RC, Pinillia J, Wuertzer SD. Verrucous carcinoma of the foot and enhancement assessment by MRI. Skelet Radiol. 2009;38(4):393–5.
García-Gavín J, González-Vilas D, Rodríguez-Pazos L, Sánchez-Aguilar D, Toribio J. Verrucous carcinoma of the foot affecting the bone: utility of the computed tomography scanner. Dermatol Online J. 2010;16(2):8.
Mirigliano E, LaTour R, Abramczuk JW. Squamous cell carcinoma of the foot mimicking osteomyelitis: a case report. J Foot Ankle Surg. 2011;50(4):480–5.
Dogan G, Oram Y, Hazneci E, Ozen S, Karincaoğlu Y, Ciralik H. Three cases of verrucous carcinoma. Australas J Dermatol. 1998;39(4):251–4.
Bhushan M, Ferguson JE, Hutchinson CE, Muston HL. Carcinoma cuniculatum of the foot assessed by magnetic resonance scanning. Clin Exp Dermatol. 2001;26(5):419–22.
Peng HH, Wang TH, Huang KG, Ng KK, Hsueh S, Chen MY. Combined ultrasound and magnetic resonance imaging findings on cervical verrucous carcinoma with endometrial invasion: a case report. J Reprod Med. 2007;52(5):441–4.
Wolf H, Platzer P, Vécsei V. Verrucous carcinoma of the tibia arising after chronic osteomyelitis: a case report. Wien Klin Wochenschr. 2009;121(1–2):53–6.
Kominami M, Fujikawa A, Tamura T, Naoi Y, Horikawa O. Retained surgical sponge in the thigh: report of the third known case in the limb. Radiat Med. 2003;21(5):220–2.
Kim CK, Park BK, Ha H. Gossypiboma in abdomen and pelvis: MRI findings in four patients. AJR. 2007;189:814–7.
Sugimura H, Tamura S, Kakitsubata Y, Kakitsubata S, Uwada O, Kihara Y, et al. Magnetic resonance imaging of retained surgical sponges. Case report. Clin Imaging. 1992;16(4):259–62.
Puri A, Anchan C, Jambhekar NA, Agarwal MG, Badwe RA. Recurrent gossypiboma in the thigh. Skelet Radiol. 2007;36 Suppl 1:S95–100.
Lo CP, Hsu CC, Chang TH. Gossypiboma of the leg: MR imaging characteristics. A Case Report. Korean J Radiol. 2003;4(3):191–3.
Kim HS, Chung TS, Suh SH, et al. MR imaging findings of paravertebral gossypiboma. AJNR. 2007;28:709–13.
Okten AI, Mehmet A, Gezercan Y. Textiloma: a case of foreign body mimicking a spinal mass. Eur Spine J. 2006;15:626–9.
Manzella A, Filho PB, Albuquerque E, Farias F, Kaercher J. Imaging of gossypibomas: pictorial review. AJR Am J Roentgenol. 2009;193(6 Suppl):S94–101.
Abdul-Karim FW, Benevenia J, Pathria MN, Makley JT. Case report 736: retained surgical sponge (gossypiboma) with a foreign body reaction and remote and organizing hematoma. Skelet Radiol. 1992;21(7):466–9.
Sawhney S, Jain R, Kakaria A, Chopra P. Marjolin’s Ulcer: radiographic and magnetic resonance appearances in two cases. Sultan Qaboos Univ Med J. 2009;9(2):162–6.
Koch H, Kowatsch E, Hödl S, Smola MG, Radl R, Hofmann T, et al. Verrucous carcinoma of the skin: long-term follow-up results following surgical therapy. Dermatol Surg. 2004;30(8):1124–30.
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Hu, B., Gorbachova, T., Belser, P. et al. Inverted verrucous carcinoma of the buttock mimicking abscess and gossypiboma: MR and pathologic correlation. Skeletal Radiol 44, 1371–1375 (2015). https://doi.org/10.1007/s00256-015-2163-z
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DOI: https://doi.org/10.1007/s00256-015-2163-z