title: Verrucous carcinoma masquerading as a giant fibroepithelial polyp.
abstract: The authors report a case of a verrucous carcinoma (VC) of the buttocks clinically simulating a giant (6.5 cm in length and 5.4 cm in greatest diameter) fibroepithelial polyp (FEP) capped by a large cutaneous horn. The growth had been present for 15 years and had never been biopsied despite numerous physical exams. VC typically presents distinctly as a large cauliflower-like growth with histological features of acanthosis, parakeratosis, minimal cytological atypia, and deep pushing epithelial borders. It is considered a low-grade, well-differentiated variant of squamous cell cancer and is commonly associated with human papillomavirus (HPV). Anogenital VC has been associated more with "low-risk" (type 6 and 11) than "high-risk" (16 and 18) HPV types. Presentation of VC as a FEP is unusual and demonstrates the necessity of maintaining a high level of clinical suspicion of anogenital growths, particularly those involving atypical features such as ulceration or the presence of a cutaneous horn.
authors.affiliation: Division of Dermatopathology, Mount Sinai School of Medicine, New York, NY 10029, USA. stephen.mercer@mssm.edu
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mercer
authors.forename: David
authors.initials: D
authors.lastname: Khalil
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Emanuel
authors.forename: Gary
authors.initials: G
authors.lastname: Goldenberg
mesh_terms: D001005:Anus Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002081:Buttocks; D018289:Carcinoma, Verrucous / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D018225:Neoplasms, Fibroepithelial / Q000175:diagnosis*; D011127:Polyps / Q000175:diagnosis*