Epitelioma cuniculatum: a propósito de un caso

RESUMENEl término carcinoma verrugoso (epitelioma cuniculatum [EC]) se atribuye a Ackerman, y corresponde a una de las tres formas inusuales de carcinoma espinocelular o de células escamosas, el cual se caracteriza por ser una neoformación bien diferenciada, de bajo grado de malignidad y con poco potencial metastásico. Las otras dos formas corresponden al tumor de Buschke-Löwenstein y en la cavidad oral, al tumor de Ackerman. Se presenta el caso de un hombre de 61 años de edad con una neoformación exofítica de aspecto verrugoso en planta del pie derecho, de 20 años de evolución, la cual fue traumatizada durante ese tiempo, de manera constante y repetitiva mediante medios mecánicos y químicos.Palabras Clave: Epitelioma Cuniculatum, Carcinoma Verrugoso plantar, Carcinoma Espinocelular. ABSTRACTThe Epithelioma Cuniculatum (EC), is one of three rare forms of low grade squamous cells carcinoma, where the topography in which it is presented is the foot, which is characterized for being a well differentiated carcinoma, it has a slow growth and a low metastasis potential. We present a 61 year old man with an exophytic lesion with a warty appearance on right foot sole, 20 years of evolution, which during that time was diagnosed as a plantar wart and it was treated and traumatized with mechanical and chemical means with de purpose of eliminate it, without success. Key Words: Cuniculatum Epithelioma, Verrucous Plantar Carcinoma, Squamous Cells Carcinoma.

A Case of Verrucous Carcinoma (Epithelioma Cuniculatum) of the Heel Mimicking Infected Epidermal Cyst and Gout

Verrucous carcinoma is a rare variant of well-differentiated squamous cell carcinoma. It usually occurs in the oral cavity, genital area, and sole. Verrucous carcinoma of the sole, also called epithelioma cuniculatum, often presents a diagnostic challenge both clinically and histopathologically. The authors report such a case that mimics infected epidermal cyst and gout clinically

Recalcitrant Verrucous Lesion

A 37-year-old woman originally presented in May 2003 with a nonhealing, painless ulcer on the plantar surface of her right foot that had been slowly increasing in size for the previous 1.5 years. Two weeks before presentation, a biopsy of the lesion, performed at another institution, had indicated a probable verrucous carcinoma. After preoperative workup, the patient underwent resection of the lesion, with clear margins and full-thickness skin grafting. The final pathologic findings were not consistent with verrucous carcinoma. A recurrent lesion was noted during a follow-up visit, and a second biopsy revealed a hyperkeratotic papillomatous verrucous lesion, type unclassified. No viral particles were isolated in the random biopsy samples. This recurrent lesion was refractory to treatment with topical acyclovir. Subsequent treatments consisted of imiquimod and CO2 laser ablation, which succeeded in reducing the lesion. Verrucous lesions can be frustrating, and the diagnosis of epithelioma cuniculatum can be difficult to prove. We report a case highly suggestive of but not definitively diagnosed as epithelioma cuniculatum and summarize the literature on this entity. (J Am Podiatr Med Assoc 96(2): 148–153, 2006)