Verrucous Carcinoma of the Anus
Definition
- Cytologically bland squamous carcinoma characterized by blunt, pushing margins
Alternate/Historical names
- Ackerman tumor
- Buschke-Loewenstein tumor
- Buschke-Löwenstein tumor (correct German spelling)
- Giant condyloma acuminatum
Covered separately
- Anal squamous cell carcinoma (usual type)
Diagnostic Criteria
- Cytologically bland
- No more than mild dysplasia
- Mitotic figures confined to basal layer unless inflamed
- Orderly maturation
- Invasion by blunt, pushing downward projections
- No single cell or sharp jagged invasion
- No vascular or perineural invasion
- Locally destructive of underlying and adjacent tissues
- May be difficult to appreciate microscopically
- Surface exophytic growth
- Acanthosis and papillomatosis
- Does not metastasize
- May involve perianal skin, anus and rectum
- Frequent transformation to usual type squamous carcinoma
- Defined by the presence of any of the following:
- Moderate to severe cytologic dysplasia
- Jagged invasion
- Metastasis
- Requires extensive sampling to exclude
- Seen in 42% of reported cases
- (Older reports of transformation of verrucous carcinoma following radiation therapy at various sites have not been supported by the recent literature)
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting/updates : 10/7/10, 11/13/11
