Track: Case Reports

Topic: Neoplasia,Carcinogensis,Tumor Biology

Abstract:

Cutaneous verrucous carcinoma is a rare variant of squamous cell carcinoma associated with human papillomavirus and chronic inflammation resulting from trauma, chemical carcinogens, and Marjolin’s ulcers. It is a well-differentiated, locally aggressive neoplasm with low malignancy potential most frequently reported in the oral, genitoanal, and plantar regions. Verrucous carcinoma of the scalp, however, is an exceedingly rare entity with few case reports in the current literature. Here, we report a case of verrucous carcinoma of the scalp in a 68-year-old Caucasian male. The patient was admitted to the hospital for worsening mental status in the context acute hyperosmolar hyperglycemic syndrome. Dermatology was consulted for a large scalp lesion identified on physical exam. The patient noted the presence of the lesion for greater than 40 years as well as progressive enlargement and occasional bleeding at the site. The patient had no known history of skin cancer. Physical examination demonstrated a malodorous 7 centimeter, nonfixed, fungating, hyperkeratotic, crusted plaque on the right parietal scalp. Computed tomography of the head without contrast demonstrated extension of the mass to the level of the galea without erosion through the outer boney cortex. No significant cervical lymphadenopathy was appreciated. Biopsy of the lesion revealed a bulbous endophytic proliferation of keratinocytes with slight nuclear variability, consistent with cutaneous verrucous carcinoma. The patient is currently pending complete surgical excision of the tumor.

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Catherine Gloss, BS in BME; MD