Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Consider Carcinoma Cuniculatum in Recurrent Foot Ulcer: A Case Report and Literature Review

  • Francisco Nunes-Abreu (Department of Plastic Surgery, Hospital General Universitario Dr. Balmis) ;
  • Ruben Hidalgo-Caro (Department of Plastic Surgery, Hospital General Universitario Dr. Balmis) ;
  • Elena Lorda-Barraguer (Department of Plastic Surgery, Hospital General Universitario Dr. Balmis) ;
  • Victor Cristobal-Redondo (Department of Anatomopathology, Hospital General Universitario Dr. Balmis) ;
  • F. Javier Cespedes-Guirao (Department of Plastic Surgery, Hospital General Universitario Dr. Balmis)
  • Received : 2023.08.03
  • Accepted : 2024.04.03
  • Published : 2024.11.15
Download PDF
⟨ Previous Next ⟩

Abstract

Carcinoma cuniculatum is a variant of squamous cell carcinoma, characterized by a slow growth with progressive crypt-like invasion of deep tissue. This tumor is frequently misdiagnosed as a benign skin lesion both clinically and histopathologically. The final diagnosis is often delayed as it requires a large sample biopsy. We report the case of a 67-year-old patient who presented to us with a recurring chronic ulcer over a surgical scar of 5 years of evolution. Only after a wide resection of the chronic ulcer was it possible to achieve the correct diagnosis of this large and poorly evolving carcinoma. The subsequent reconstruction with a musculocutaneous gracilis free flap allowed the patient to walk again.

Keywords

References

  1. McKee PH, Wilkinson JD, Black MM, Whimster IW. Carcinoma (epithelioma) cuniculatum: a clinico-pathological study of nineteen cases and review of the literature. Histopathology 1981;5(04):425-436 
  2. Kunc M, Biernat W. Carcinoma cuniculatum of the lower leg: a case report and proposed diagnostic criteria. Am J Dermatopathol 2019;41(11):855-857 
  3. Shwe Daniel S, Cox SV, Kraus CN, Elsensohn AN. Epithelioma cuniculatum (plantar verrucous carcinoma): a systematic review of treatment options. Cutis 2023;111(02):E19-E24 
  4. Aird I, Johnson HD, Lennox B, Stansfeld AG. Epithelioma cuniculatum: a variety of squamous carcinoma peculiar to the foot. Br J Surg 1954;42(173):245-250 
  5. Ye Q, Hu L, Jia M, Deng LJ, Fang S. Cutaneous verrucous carcinoma: a clinicopathological study of 21 cases with long-term clinical follow-up. Front Oncol 2022;12:953932 
  6. Prince ADP, Harms PW, Harms KL, Kozlow JH. Verrucous carcinoma of the foot: a retrospective study of 19 cases and analysis of prognostic factors influencing recurrence. Cutis 2022;109(03):E21-E28 
  7. Penera KE, Manji KA, Craig AB, Grootegoed RA, Leaming TR, Wirth GA. Atypical presentation of verrucous carcinoma: a case study and review of the literature. Foot Ankle Spec 2013;6(04):318-322 
  8. Knobler RM, Schneider S, Neumann RA, et al. DNA dot-blot hybridization implicates human papillomavirus type 11-DNA in epithelioma cuniculatum. J Med Virol 1989;29(01):33-37 
  9. Arisi M, Zane C, Edu I, Battocchio S, Petrilli G, Calzavara-Pinton PG. Carcinoma cuniculatum of the foot invading the bone mimicking a pseudoeptheliomatous reaction to an acute osteomyelitis. Dermatol Ther (Heidelb) 2016;6(01):95-99 
  10. Vlahovic TC, Klimaz TL, Piemontese MK, Zinszer KM. Plantar verrucous carcinoma: an unusual case of bone invasion and osteomyelitis. Adv Skin Wound Care 2009;22(12):554-556 
  11. Miller SB, Brandes BA, Mahmarian RR, Durham JR. Verrucous carcinoma of the foot: a review and report of two cases. J Foot Ankle Surg 2001;40(04):225-231 
  12. Sakakibara S, Tokiyoshi T, Hashikawa K, Terashi H. Necessity of distinguishing verrucous carcinoma from verrucous skin lesion overlaying residual skin staples in an area of sensory loss: a case report. Eplasty 2015;15:e23 
  13. Nakamura Y, Kashiwagi K, Nakamura A, Muto M. Verrucous carcinoma of the foot diagnosed using p53 and Ki-67 immunostaining in a patient with diabetic neuropathy. Am J Dermatopathol 2015;37(03):257-259 
  14. Wasserman PL, Taylor RC, Pinillia J, Wuertzer SD. Verrucous carcinoma of the foot and enhancement assessment by MRI. Skeletal Radiol 2009;38(04):393-395 
  15. di Meo N, Stinco G, Nan K, Degrassi F, Cova MA, Trevisan G. Carcinoma cuniculatum: usefulness of radiological assessment. Indian J Dermatol 2016;61(01):123 
  16. Yoshitatsu S, Takagi T, Ohata C, Kozuka T. Plantar verrucous carcinoma: report of a case treated with Boyd amputation followed by reconstruction with a free forearm flap. J Dermatol 2001;28(04):226-230 
  17. Spyriounis PK, Tentis D, Sparveri IF, et al. Plantar epithelioma cuniculatum: a case report with review of the literature. Eur J Plast Surg 2004;27:253-256 
  18. Pu LL, Medalie DA, Lawrence SJ, Vasconez HC. Reconstruction of through-and-through gunshot wounds to the feet with free gracilis muscle flaps. Ann Plast Surg 2003;50(03):286-291 
  19. Verheyden CN, McLaughlin B, Law C, Gallego K, Ketch L, White RR. Through-and-through gunshot wounds to the foot: the "Fearless Fosdick" injury. Ann Plast Surg 2005;55(05):474-478 
  20. Georgia Kay B, Kandamany N. Don't shoot yourself in the foot: reconstruction of a through-and-through gunshot wound of the foot. Plast Reconstr Surg Glob Open 2019;7(07):e2314