title: Verrucous carcinoma of the larynx: a review of 53 patients.
abstract: BACKGROUND
  Verrucous carcinoma of the larynx is a rare laryngeal neoplasm that can be confused with a benign process. Although usually curable at an early stage, it can be locally aggressive if left untreated. We describe our experience with this tumor and make recommendations for diagnosis and treatment.
  
  
  METHODS
  From 1960 through 1990, 53 patients received initial treatment for verrucous carcinoma of the larynx at the Mayo Clinic. We retrospectively reviewed the presentation, diagnosis, treatment, and outcomes in these patients. All cases were confirmed by histologic examination.
  
  
  RESULTS
  All but two patients were men, and most were smokers. Most tumors were found in the glottis, and 72% were T1 lesions at presentation. Six patients had hybrid tumors consisting of conventional squamous cell carcinoma along with the verrucous component. Sixteen patients had lesions that had been diagnosed as benign before they were seen at our institution. Treatment ranged from transoral excision to laryngopharyngectomy. Ten patients experienced recurrence, but only two patients died of the tumor. No pure verrucous lesion metastasized, and overall survival was similar to that of an age- and sex-matched cohort from the Western North Central U.S. white population.
  
  
  CONCLUSIONS
  When discovered early, verrucous carcinoma of the larynx can be treated by local excision with good results; extensive lesions, however, may require more-aggressive procedures. Close communication between the pathologist and the clinician as well as adequate biopsy is essential for diagnosis. Patients with a conventional squamous cell carcinoma coexistent with a verrucous lesion must be treated as if they had invasive squamous cell carcinoma.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Orvidas
authors.forename: K D
authors.initials: KD
authors.lastname: Olsen
authors.forename: J E
authors.initials: JE
authors.lastname: Lewis
authors.forename: V J
authors.initials: VJ
authors.lastname: Suman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018289:Carcinoma, Verrucous / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016019:Survival Analysis