Pathology – MCQ 100 – Fungating lesion in the oral cavity of an elderly tobacco chewer

A 70 year old male who has been chewing tobacco for the past 50 years presents with a 6 months history of a large, fungating, soft papillary lesion in the oral cavity. The lesion has penetrated into the mandible. Lymph nodes are not palpable. 2 biopsies taken from the lesion proper show benign papillomatosis with hyperkeratosis infiltrating the subjacent tissues. The most likely diagnosis is :
A. Squamous cell papilloma
B. Squamous cell carcinoma
C. Verrucous carcinoma
D. Malignant mixed tumour

Correct answer : C. Verrucous carcinoma

Verrucous carcinoma – also known as giant condyloma acuminatum / Buschke Lowenstein tumour are considered to be an intermediate stage between condyloma acuminatum and squamous cell carcinoma. They tend to be localised. They can be cured by wide excision. They can undergo malignant transformation.

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