Concluded Case

VERRUCOUS CARCINOMA (ON ATTACHED GINGIVA)-A RARE CASE.

Good Morning Everyone..!! A Rare Case of "VERRUCOUS CARCINOMA" on attached gingiva reported in a 38 years old male patient. Patient reported with C/ C of white painless brush like growth over the lower left gum region since 8 months. Lesion was gradual in onset increasing in size from last 2.5 months and had chronic irritation while chewing & tooth brushing. H/O chronic tobacco chewing since 15 to 20 yr and smoking since 5 to 7 yr and used to place the tobacco quid in lower Rt & Lt buccal vestibule. O/E it was pedunculated, soft, non scrapable, non tender. P/D- Squamous papilloma and D/-1). verrocous keratosis, 2).hyperplastic candidiasis, 3).leukoplakia, 4).Focal epithelial hyperplasia were made. IOPA 34 35 36 showed no bony involvement. H/P suggestive of VERRUCOUS Hyperplasia with moderate epithelial dysplasia. Kindly review and share your opinions...Thank You.

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Verrucous carcinoma or Ackerman's carcinoma or Squamous papilloma is the most common benign epithelial tumor of the oral mucosa. Identified as an exophytic proliferation giving rise to papillary lesions with finger-like projections - Cauliflower like or Wart like appearance. It constitutes 2.5% of the Site: oral cavity, larynx, bronchial tree, esophagus, bladder, anus and genital tract. Etiology: Human Papillomavirus (HPV) other as :alcohol, tobacco chewing, smoking Approximately 70% of conditions of higher degree of malignant transformation. Males more than in women, and between 30 and 34 years and between 60 and 64 years. According to the site of infection, HPVs that infect the oral cavity are considered much cutaneous. Its transmission is diverse: it can occur in the perinatal period and later in life, by sexual contact and autoinoculation, although some authors also suggest a possible transmission by saliva, as the main method of transmission of HPV in mouth. Diagnosis: Biopsy Tt: surgical excision should be performed as soon as possible. NOTE: Hybrid verrucous-squamous carcinoma” term has seldom been used in the literature with most of the cases relating to the transformation of the VC to frank SCC post radiation treatment.
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Verrucous carcinoma or Ackerman's carcinoma or Squamous papilloma is the most common benign epithelial tumor of the oral mucosa. Identified as an exophytic proliferation giving rise to papillary lesions with finger-like projections - Cauliflower like or Wart like appearance. It constitutes 2.5% of the Site: oral cavity, larynx, bronchial tree, esophagus, bladder, anus and genital tract. Etiology: Human Papillomavirus (HPV) other as :alcohol, tobacco chewing, smoking Approximately 70% of conditions of higher degree of malignant transformation. Males more than in women, and between 30 and 34 years and between 60 and 64 years. According to the site of infection, HPVs that infect the oral cavity are considered much cutaneous. Its transmission is diverse: it can occur in the perinatal period and later in life, by sexual contact and autoinoculation, although some authors also suggest a possible transmission by saliva, as the main method of transmission of HPV in mouth. Diagnosis: Biopsy Tt: surgical excision should be performed as soon as possible. NOTE: Hybrid verrucous-squamous carcinoma” term has seldom been used in the literature with most of the cases relating to the transformation of the VC to frank SCC post radiation treatment.
Amazing, well narrative illustration @Dr. Haritma Nigam ma'am,, thanks for sharing :)
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Nice case @Dr. Saloni Arora ur skills in case presentation are exemplary. Verrucous carcinomas are slow-growing, exophytic, well-demarcated hyperkeratotic lesions. They typically present as extensive, white, warty lesions. Managment comprises of surgical excision ,habit counselling and oral hygiene reinforcement. The prognosis of verrucous carcinoma is better than that of other kinds of life-threating malignant tumors. However it warrants close clinical follow-up to intercept and prevent possibility of recurrence or transformation to SCC .
Thank you so much @Dr. Kausar Yadwad ,very well narrative and precisely explained.
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Nice case presentation.... To the point .. Do you have any follow up pics? Have you seen any recurrence....? Has patient left all his habits and showed any interest to message the habits after undergoing this treatment?
Thank you mam
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If adequately sampled , approximately 20 percent of verrucous carcinoma contains SCC..... So.... we should do neck dissection even in No(N zero) cases.... otherwise recurrence will occurs.
yes @Dr. P Kartheek Reddy Sir you are absolutely right,, patient is yet not came for follow up so we can't gather much information about recurrence and post-op records,, but yes chances of recurrence are higher in such cases. thanks for putting your opinion sir. Will surely keep a record for the same.
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Good morning @Dr. Saloni Arora . Good case and legendary case presentation. Thanks for Sharing :)
Hehe...thanks @Dr. Ashish Tiwari :)
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NICE PRESENTATION.. DR Saloni Arora..Tnxs FOR SHARING..
Thank you @Dr. Kute Ankush Sir. Regards.
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Well explained Dr.
Thank you doctor
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good case
keep sharing such good cases dr. all d best
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