Two Cases of Nasal and Paranasal Verrucous Carcinoma

  • Takemoto Yousuke
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine
  • Hirose Yoshinobu
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine
  • Okinaka Yousuke
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine
  • Mikuriya Takefumi
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine
  • Okuda Tsuyoshi
    Department of Otolaryngology, Ubekohsan Central Hospital Corp.
  • Hara Hirotaka
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine
  • Yamashita Hiroshi
    Department of Otolaryngology, Yamaguchi University, Graduate School of Medicine

Abstract

<p>Verrucous carcinoma originating from various sites has been reported since Ackerman first reported an intraoral case in 1948. Histologically, the tumor is composed of atypical low squamous epithelium showing papillary growth, with strong cornification; in regard to the differentiation grade, the tumor is a subtype of well differentiated squamous cell carcinoma. There are scarce reports from foreign countries of verrucous carcinoma arising in the rhinosinus. Extensive resection is necessary, but it is said to be generally associated with a good prognosis. There are many reports recommending against the use of radiotherapy as the treatment modality of first choice, because local control is insufficient and radiotherapy is associated with a high risk of anaplastic transformation of the tumor.</p><p>We encountered two cases of verrucous carcinoma of the rhinosinus. Case 1 was a 44-year-old woman with verrucous carcinoma of the left frontal sinus, complicated by a brain abscess. Case 2 was a 78-year-old woman with verrucous carcinoma (T4aN0M0 Stage IVa) of the left nasal cavity, who was treated by radiation plus cetuximab therapy. This verrucous carcinoma showed strong EGFR expression, therefore, cetuximab was effective. There is a case following fatal course in verrucous carcinoma, and it is necessary to pay attention.</p>

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