Indian Journal of Dermatology (Jan 2005)
Carcinoma cuniculatum at various anatomical sites
Abstract
Carcinoma cuniculatum, a low grade squamous carcinoma of plantar skin was first described in 1954. Even after 50 years, biopsy errors are common with delay in diagnosis. Clinico-morphologica1 features in 12 patients of carcinoma cuniculatum, in a period of three and a half years are studied. The aim is to draw attention to the sites of occurrence of this tumor other than the sole and to have better understanding of the diagnostic difficulties. The sites of occurrence of these tumors according to frequency were foot followed by flank, leg, face and palm. The tumors presented with ulcerated, fungating masses with fine papillary architecture. Microscopic examination of the tumors revealed bulbous acanthosis, parakeratosis and a well defined lower border, circumscribed by chronic inflammatory cells. No lymph node metastasis were recorded in any of the cases. Wide local excision with at least five mm free surgical margin was the treatment of choice. A transmetatarsal and above wrist amputation was required in two patients. Carcinoma cuniculatum should always be suspected in a nonhealing ulcer or verrucous growth of long standing duration. Superficial and small biopsies are unsatisfactory. Benign appearance on histopathology of this tumor needs to be interpreted in proper clinical settings.
