From Warts to Cancer: A Case of Verrucous Carcinoma of the Vulva

Verrucous carcinoma of the vulva is a rare subtype of squamous cell carcinoma that can arise from preexisting lesions such as genital warts. This type of carcinoma is notable for its low metastatic potential but requires precise diagnosis and treatment.

We present the case of a 40-year-old, Para 4 lady who presented with a large mass on her groin that had been diagnosed as warts. Over four years, she received multiple treatments, including imiquimod, TCA, radiofrequency ablation, CO₂ laser, and cryotherapy, without any relief. She also experienced difficulty walking due to the lesions and developed depression. A simple vulvectomy with local bilateral transpositional flaps was performed, and the final histopathology report revealed verrucous carcinoma with free margins all around the tumor and a depth of 1 mm.

Treatment of verrucous carcinoma typically involves surgical excision with a wide margin of normal tissue, and radiation therapy is contraindicated. The management of this challenging condition often necessitates a multidisciplinary approach involving gynecologists, dermatologists, and pathologists. Accurate diagnosis and timely treatment are essential for optimal patient outcomes. The prognosis for patients with verrucous carcinoma is generally favorable, with a low risk of distant metastasis and a high likelihood of long-term survival if the disease is diagnosed and treated promptly. This case highlights the importance of considering verrucous carcinoma in patients with persistent vulvar lesions and the effectiveness of surgical excision in achieving positive outcomes.