Oral verrucous carcinoma: A retrospective analysis for clinicopathologic features

Aim: To study the clinicopathological features of oral verrucous carcinoma (VC). Methods: Archives of the department were retrieved for verrucous lesions. After thorough histopathologic examination, 10 cases were confirmed as VC. Age, sex, site, tobacco habit, clinical presentation, and histologically, the presence of dysplasia and koilocytic changes were studied. Results: Oral VC showed a distinct male preponderance with male: female ratio of 8: 2 and occurring predominantly in sixth and seventh decade. Tobacco association in the form of chewing (50%), smoking (40%) or both (10%) was found in all the cases. In chewers, the site of lesion corresponded to the site of tobacco placement that is gingivobuccal sulcus. In smokers, the posterior part of the oral cavity was affected, and the lesions were extensive. Painless, exophytic, cauliflower-like growth was the most common presentation with surrounding whitish (leukoplakic) mucosa. Fifty percentage of the cases showed human papilloma virus-induced changes in the epithelium. Dysplasia was seen in two cases. Conclusion: Oral VCs are invariably associated with tobacco habits. In smokers, the lesions are extensive, affecting the posterior parts of the oral cavity. Although evidence of viral infection was seen but its role as an etiological agent is still controversial. Site and depth of the biopsy along with thorough histopathological sampling is essential to avoid erroneous diagnosis.