A 70 year old male who has been chewing tobacco for the past 50 years presents with a six months history of a large, fungating, soft papillary lesions in the oral cavity penetrating into the mandible. Lymph nodes are not palpable. Two biopsies taken from the lesion proper show benign appearing papillomatosis with hyperkeratosis and acanthosis infiltrating the subjacent tissues. The most likely diagnosis is:
Verrucous carcinoma is also referred to as a giant condyloma accuminatum or buschke lowenstein tumor of the oral cavity. It is considered an intermediate lesion between condyloma accuminata and invasive squamous cell carcinoma. These cancers tend to localize and are cured by wide excision, however they can undergo malignant transformation into an invasive squamous cell carcinoma.
Squamous cell papilloma
Squamous cell carcinoma
Verrucous carcinoma
Malignant mixed tumour