ORIGINAL ARTICLE   

European Journal of Oral and Maxillofacial Surgery 2021 December;5(3):100-4

DOI: 10.23736/S2532-3466.21.00249-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Management of verrucous carcinoma by laser ablation: observational study of 11 cases

Rusy BHALLA ✉, Seemantini BHALLA, Duleep BHONSALE

Department of Oncology, Orchid Center for Laser Surgery, Mumbai, India

BACKGROUND: Verrucous carcinoma or Ackerman’s tumor comprise 2% to 5% of oral cancer malignancies. It has a higher prevalence in patients with use of tobacco and related products. It is also associated with HPV infection. It is more common in middle aged and elderly individuals. Verrucous carcinoma is a locally proliferative disease and does not metastasize. It will not invade the underlying bone and muscles and as such it is localized to mucosa. The verrucous carcinoma has the propensity to turn carcinomatous if not treated for a long time. Histopathologically it is characterized by dysplasia without invasion of underlying dermis. Verrucous carcinoma is conventionally treated by a mutilating surgery or radiation. Both these options have side effects which are not acceptable to patients. Laser gives an easier way to handle this condition without any of side effects of above procedures. This was a retrospective analysis of 11 verrucous carcinoma cases.
METHODS: Treatment was given in the form of laser ablation of the growth. Laser was used to ablate the visualized tumor and followed up with minor ablative sessions. Sites included were buccal mucosa 50%, RMT area with buccal mucosa 15%, tongue 25%, 10% had on genitalia. No radiation or any other chemotherapy was administered.
RESULTS: Patients were followed up from 1 to 4 years. All patients were alive at the end of 4 years and 2 patients had a malignant transformation due to inadequate follow-up. There was no mutilation, or any side effects noted of the laser procedure.
CONCLUSIONS: Though surgery is mainstay of treatment for Verrucous carcinoma. Laser ablation can be offered as an alternative treatment option for patients unwilling for surgery or radiation.

KEY WORDS: Carcinoma, verrucous; Mouth; Laser therapy