Carcinoma cuniculatum of the nasal tip

Carcinoma cuniculatum, also known as cutaneous verrucous carcinoma, is a rare, low-grade, well-differentiated squamous cell carcinoma usually involving the foot. It is often locally aggressive but rarely metastatic. Only 10 cases involving the skin of the face (except the lips and scalp) have been reported. We describe a 74-year-old man who presented with carcinoma cuniculatum on the nasal tip arising from a keratoacanthoma-like lesion. To our knowledge, this is the first report of such a case in the literature. Literature related to carcinoma cuniculatum is also reviewed, and the challenges in diagnosis and choice of treatment are also described. In this case, the patient initially presented with keratoacanthoma on the nasal tip, and rapid recurrence with a verrucous mass occurred 1 month following tumor excision. Wide excision with 5-mm safe margins and full-thickness skin graft resurfacing were performed smoothly after recurrence. Histopathologic examination revealed carcinoma cuniculatum. The patient recovered uneventfully, and no recurrence of the lesion was reported over a 62-month period of observation. Overall, the prognosis of carcinoma cuniculatum is usually favorable. However, early diagnosis and treatment of carcinoma cuniculatum are crucial by clinicopathological standards. General clinical awareness of this entity contributed to more appropriate and timely treatment. Copyright (C) 2016, Taiwan Surgical Association. Published by Elsevier Taiwan LLC.