title: Plantar verrucous carcinoma: report of a case treated with Boyd amputation followed by reconstruction with a free forearm flap.
abstract: Verrucous carcinoma is a relatively rare, well-differentiated, squamous cell carcinoma. Although it is slow-growing and mimics benign skin lesions, it can cause extensive local destruction that necessitates amputation. It is often underdiagnosed as a benign tumor in its early course. We report a case of extensive verrucous carcinoma on a recalcitrant ulcer and a severe long-standing scar around it on the sole of the right forefoot, which had been treated as a benign tumor for more than two years. We treated it successfully with amputation of the foot and were able to spare the heel by using a free innervated forearm flap to cover the defect at the stump. The present case should remind clinicians that a verrucous lesion developing on a refractory ulcer may be a complex malignant neoplasm; an accurate diagnosis is difficult without a combination of clinical features and pathological findings from an adequately deep specimen.
authors.affiliation: Department of Plastic Surgery, Osaka National Hospital, 2-1-14, Hoenzaka, Chuou-ku, Osaka 540-0006, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yoshitatsu
authors.forename: T
authors.initials: T
authors.lastname: Takagi
authors.forename: C
authors.initials: C
authors.lastname: Ohata
authors.forename: T
authors.initials: T
authors.lastname: Kozuka
mesh_terms: D000671:Amputation, Surgical / Q000379:methods*; D018289:Carcinoma, Verrucous / Q000473:pathology / Q000601:surgery*; D005534:Foot Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps