Diagnosis and Management of Verrucous Carcinoma of the Esophagus

Abstract

Verrucous esophageal carcinoma is an extremely rare subtype of squamous cell carcinoma of the esophagus that is characterized by a friable exophytic mass but is often deceptively low-grade and superficially well-differentiated on mucosal biopsies, making pathologic diagnosis challenging. Distant metastasis is rare in these tumors. Therefore, early diagnosis is crucial as surgical resection is frequently curative. Conversely, delay in diagnosis can lead to extensive local invasion and result in severe morbidity and death. In this article, we will outline the history of verrucous esophageal carcinoma, review the current clinical understanding based on cases of verrucous carcinoma described thus far, and discuss recent advances in understanding of the pathogenesis of verrucous esophageal carcinoma that may aid in molecular diagnostics.