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Its Unique Etiology and Association with Human Papilloma Virus https://www.scientificarchives.com/journal/journal-of-cancer-immunology Journal of Cancer Immunology Commentary Verrucous Carcinoma of the Esophagus: Its Unique Etiology and Association with Human Papilloma Virus Satoshi Tabuchi1, Kazuo Koyanagi2*, Soji Ozawa2, Shigeyuki Kawachi1 1Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, 193- 0998, Japan 2Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan *Correspondence should be addressed to Kazuo Koyanagi; [email protected] Received date: May 02, 2020, Accepted date: May 14, 2020 Copyright: © 2020 Tabuchi S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Verrucous carcinoma of the esophagus (VCE) is a rare variant of esophageal squamous cell carcinoma. Most cases of VCE presents as an exophytic, slow-growing mass with a superficial growth pattern. Even when VCE exhibits a characteristic pattern during an endoscopic examination, it is very difficult to make a definitive diagnosis of VCE preoperatively, because biopsy specimens are only characterized by nonspecific acanthosis and hyperkeratosis or parakeratosis associated with inflammation. As well as the characteristics of VCE, the etiology of the disease is even unique. VCE is typically associated with chronic mucosal irritation such as reflux esophagitis, achalasia, and lye ingestion that has resulted in esophageal inflammation or a long-term local disease process in addition to the classic risk factors of nicotine and alcohol consumption. Recent studies had indicated that human papilloma virus (HPV) infection might be associated with VCE. While HPV may be related to VCE initiation, involvement of HPV in the etiology of VCE requires further investigation. VCE’s etiology and therapeutic strategy, including the vaccination against HPV, should be established. Keywords: Verrucous carcinoma, Esophagus, Human papilloma virus Introduction (HPV) infection, stating that HPV may be involved in the carcinogenesis of VCE. Although VCE exhibits the same Verrucous carcinoma is an extremely rare disease, typical appearance and growth patterns as VSC in other and it is unique in terms of its appearance, growth organs, because of the paucity of cases neither its etiology pattern, and etiology. In 1948, Ackerman first described nor therapeutic strategies have not been well assessed. verrucous squamous cell carcinoma (VSC) as a variant In this commentary we reviewed previous reports and of oral squamous cell carcinoma [1], and he collected discussed VCE, in particular association between its 31 cases of oral neoplasms under the name, “Verrucous etiology and HPV infection. Carcinoma of the Oral Cavity.” VSC was described as having the following characteristics: slow growing, Review of the Literature Concerning VCE well-differentiated, irregular surface appearance with a propensity to spread locally, and VSC has subsequently We used the keywords “esophagus” and “verrucous been reported in the mouth, nasal cavity, larynx, glans carcinoma” to search the literature in the PubMed penis, scrotum, vulva, vagina, cervix, endometrium, database during the period from 1983 to 2018 (Table urinary bladder, and anorectal region. Verrucous 1). Only 48 cases of VCE (including our case) have been carcinoma of the esophagus (VCE) is a rare variant of described since Minielly’s first report of VCE [2]. Males esophageal squamous cell carcinoma. In 1967, Minielly have predominated, but the proportion of women with et al. described VCE for the first time in a series of five VCE (28 males, 18 females, 2 gender unknown) has cases [2]. Interestingly, there are reports suggesting an been higher among esophageal squamous cell carcinoma association between VCE and human papilloma virus patients. The male-female ratio is about 3:2, and VCE J Cancer Immunol. 2020 Volume 2, Issue 2 44 Tabuchi S, Koyanagi K, Ozawa S, Kawachi S. Verrucous Carcinoma of the Esophagus: Its Unique Etiology and Association with Human Papilloma Virus. J Cancer Immunol. 2(2): 44-51. Tumor Age/ Chief Past 1st Treat- No Author Year Location size Prognosis T N M Sex complaint history diagnosis ment (cm) Minielly 1 1967 58/M dysphagia achalasia upper benign 9×8.5 OPE 1m dead 3 0 0 [2] large 2 1967 70/F dysphagia diverticulum upper VC RT unknown N/A N/A N/A tumor large 3 1967 70/F dysphagia achalasia upper VC RT 2m dead 4 N/A N/A tumor 4 1967 36/M dysphagia diverticulum lower SCC 9×8 OPE 2m dead 4 + N/A 5 1967 57/M dysphagia none lower benign N/A BSC 5m dead N/A N/A N/A Parkinson 6 1970 76/M melena obstruction middle SCC 7.5 BSC 1m dead 1b 0 0 [23] Meyerow- hematem- OPE, 7 1971 45/M none lower benign 8×5.5 9m dead 2 N/A 0 itz [24] esis RT Sridher 8 1980 54/M dysphagia hiatal hernia lower benign 2 OPE unknown 1b 0 N/A [25] Sakurai 9 1983 78/M dysphagia none upper VC 10×5 CT 6m alive 4 N/A N/A [7] large 10 Agha [26] 1984 66/M dysphagia acid burn upper VC BSC 2m dead 4 N/A N/A tumor Barbier 11 1987 50/F dysphagia hiatal hernia lower VC N/A OPE 10m alive 1a 0 0 [27] Koerfgen traumatic 12 1988 75/M dysphagia lower benign N/A OPE 36m alive 2 0 0 [28] stenosis J 45 Cancer Immunol.13 2020 1988 54/? dysphagia none lower benign 6.5×6.5 OPE 18m alive 2 0 0 Volume 2, Issue 2 Tabuchi S, Koyanagi K, Ozawa S, Kawachi S. Verrucous Carcinoma of the Esophagus: Its Unique Etiology and Association with Human Papilloma Virus. J Cancer Immunol. 2(2): 44-51. Jasim 14 1990 79/M dysphagia hiatal hernia lower benign 9×6 BSC dead N/A 0 0 [29] Biemond dysphagia, 15 1991 76/F RE middle benign 15 BSC 1m dead 4 0 0 [4] dyspnea Roach 16 1993 67/M dysphagia achalasia upper benign 7 BSC 2m dead 4 0 0 [30] Garrard 17 1994 51/F dysphagia none middle VC 10 OPE 9m alive 2 0 0 [31] odynopha- 18 Kavin [8] 1996 76/? none lower benign N/A BSC 1m dead N/A + N/A gia 19 Malik [32] 1996 66/M dysphagia RE lower benign 5×2 OPE 36m alive 2 0 0 20 Tajiri [33] 2000 40/M none none lower VC 0.6×0.8 EMR 48m alive 1a 0 0 Ereno 21 2001 65/F dysphagia none middle N/A 11 OPE N/A N/A N/A N/A [34] Osborn 22 2003 67/M dysphagia achalasia lower benign 8×8 OPE 9m alive 2 0 0 [35] abdominal 23 Devlin [3] 2004 56/F none lower benign 2.7 OPE 14m alive 1b 0 0 pain Pfitzmann 24 2004 66/F N/A none lower N/A N/A OPE N/A N/A N/A N/A [36] Liberale Antivi- 25 2005 41/M chest pain none lower VC N/A 6m dead 4 N/A N/A [18] ral Tx 26 Na [37] 2009 50/M dysphagia RE middle VC 7.5×4.8 OPE 6m alive 2 0 0 27 Oh [5] 2009 73/F dysphagia RE upper benign 3.5 BSC 23m alive 1a 0 0 J 46 Cancer Immunol.Garcia 2020 28 2010 71/F dysphagia obstruction middle benign 3.9×2.5 OPE N/A 2 0 0 Volume 2, Issue 2 [38] Tabuchi S, Koyanagi K, Ozawa S, Kawachi S. Verrucous Carcinoma of the Esophagus: Its Unique Etiology and Association with Human Papilloma Virus. J Cancer Immunol. 2(2): 44-51. Tonna 29 2010 61/M dysphagia none extensive benign 10 OPE 12m alive 1b 0 0 [19] Munson 30 2010 63/F dysphagia none extensive VC 16 CRT N/A 3 + 0 [39] Taniyama 31 2012 74/M nausea none middle benign 5 OPE 6m alive 2 0 0 [40] Vieira 32 2013 58/M dysphagia none N/A benign N/A OPE 1m dead 2 0 0 [22] Sweetser OPE, 33 2014 61/M dysphagia N/A extensive N/A N/A 72m alive 2 0 0 [41] CRT 34 2014 73/F dysphagia N/A lower N/A N/A CRT 36m alive N/A N/A N/A 35 2014 66/M dysphagia N/A lower N/A N/A OPE 120m alive 1 0 0 36 2014 70/F dysphagia N/A extensive N/A N/A OPE 6m dead 1 0 0 37 2014 71/M dysphagia N/A middle N/A N/A N/A 36m dead 2 0 0 38 2014 57/M N/A N/A lower N/A N/A N/A N/A 3 0 0 39 2014 75/F dysphagia N/A lower N/A N/A N/A N/A 1 0 0 40 2014 62/M dysphagia N/A extensive N/A N/A OPE 96m alive 3 0 0 41 2014 63/F dysphagia N/A extensive N/A N/A CRT 12m alive 3 0 0 OPE, 42 2014 68/M dysphagia N/A extensive N/A N/A 24m alive 1 0 0 CRT 43 2014 62/F dysphagia N/A middle N/A N/A OPE 24m alive 1 0 0 44 Abe [42] 2016 68/M none N/A lower benign 1 ESD N/A 1a 0 0 45 Cox [43] 2017 62/M dysphagia none middle SCC 9.5 OPE N/A 1b 0 0 Hoffmann systemic 46 2018 61/M dysphagia lower VC N/A OPE 24m alive 1b 0 0 [44] sclerosis 47 2018 52/F dysphagia none lower VC 10 OPE 24m alive 2 0 0 Tabuchi 48 2020 56/F dysphagia none lower benign 12 OPE 96m alive 3 0 0 [10] J 47 Cancer Immunol.
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