Warts – Verrucous Carcinoma

Warts can occasionally turn into a verrucous carcinoma, which is a low grade cancer.  It can be viewed as a very well differentiated squamous cell cancer with low metastatic potential.  Typically, verrucous carcinomas are locally destructive as they enlarge and burrow into the muscle and bone.  The most common location for a verrucous carcinoma is the plantar foot, as it is an area that a wart may grow for years without being noticed.  HPV is the most common cause of a verrucous carcinoma but they can also arise in burn scars or secondary to tobacco usage.  Treatment of a verrucous carcinoma is surgical using a 4mm wide excision.  Mohs surgery can also be used to treat verrucuous carcinomas.  It is very important that a verrucous carcinoma never be treated with radiation therapy as this can convert it into a high grade poorly differentiated squamous cell cancer with an increased risk of metastasis.