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Verrucous Carcinoma — NDEB AFK MCQ

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HardOral PathologyVerrucous CarcinomaNDEB AFK

A 65-year-old male smoker presents with an exophytic, well-demarcated, verrucous, white lesion on the buccal mucosa that has been slowly enlarging for 2 years. Biopsy shows broad, bulbous rete ridges pushing into the underlying connective tissue without evidence of invasion through the basement membrane. What is the most likely diagnosis?

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Correct answer: A — Verrucous carcinoma

Verrucous carcinoma (Ackerman tumour) is a well-differentiated, low-grade variant of squamous cell carcinoma characterised by exophytic, verrucous, papillomatous growth. Histologically, it shows broad, well-differentiated rete ridges with a pushing (not infiltrating) border, parakeratin plugging, and minimal cytological atypia. It is strongly associated with smokeless tobacco use. It has a good prognosis with wide local excision and a very low metastatic potential. Radiation therapy is controversial as it may induce anaplastic transformation.

Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016