Abstract

VERRUCOUS CARCINOMA, HYBRID VERRUCOUS CARCINOMA & HPV INFECTION: A RETROSPECTIVE RE-EVAUATION & ANALYSIS

*Dr. Sonalee Shah, Dr. Fatema Saify, Dr. Nidhi Tiwari and Dr. Amit Wasti

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Abstract

Oral Verrucous carcinoma(OVC), is a lesion that was first described by Ackerman & its characteristics include: slow and local growth, invasive nature and rarity of metastases even in advanced cases. Its clinical behavior of invasion, proliferation and exophytic exuberance of epithelial tissue are quite unique to the lesion and thus, has features reflective of both a benign verrucous lesion and an oral squamous cell carcinoma. The common variants of verrucous carcinoma are Oral verrucous carcinoma and Hybrid verrucous carcinoma. The primary purpose of this retrospective study was to investigate the clinical distribution pattern by sex, age, habit and site of Verrucous carcinoma in Chhattisgarh in the last decade and correlate them with the habits and habit duration alongwith histopathological parameters like Dysplasia and its degree, lymphocytic infiltration and nuclear changes indicating HPV infection. The archieves of histopathologically diagnosed Oral Verrucous carcinoma were re-evaluated to delineate Verrucous Carcinomas from Hybrid verrucous carcinomas with their clinical data, habit history and lesion History. On re-evaluation of the histopathological slides from archives it was noted that approximately half the lesions were histologically Hybrid verrucous carcinoma & HPV infection related microscopic changes were evident in histology of both types indicating its minimal role in defining the histological variant. The re-evaluation was an attempt to stress the fact that due to high similarity in staging and grading, it is very important to diagnose and differentiate Oral hybrid VC from OVC owing to the various common factors that influence their behavior variably and more importantly, due to a distinct difference in their prognosis.

Keywords: Oral verrucous carcinoma, Hybrid verrucous carcinoma, Human Papilloma virus, Koilocytes.