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Verrucous carcinoma is a very rare type of squamous cell carcinoma, slow-growing and found in the oropharynx, larynx, penis, scrotum, vulva, vagina, cervix, endometrium, bladder and anorectal region. It is believed to be related to chronic irritation or inflammation of the mucosa due to smoking, drinking, achalasia, esophagitis, ingestion of lye or esophageal diverticulum.
The main symptom is dysphagia, associated with great weight loss. Patients are usually admitted in an advanced state of malnutrition, especially due to delays in diagnosis, leading to high surgical risk and mortality1,2,4,5,6,7,8,9,10
Man aged 64, smoker for 44 years, having stopped for 16 years. He presented with rapidly progressive dysphagia, from solid to liquid in four months, associated with weight loss of 18 kg in the period.
Initially admitted for investigation at another facility where he underwent upper gastrointestinal endoscopy, which showed whitish plaques in the entire esophagus and biopsies showing Candida sp. He was treated with intravenous antifungal and remained hospitalized for 28 days, but there was no improvement of the dysphagia, on the contrary, it progressed to inability to swallow saliva. A new endoscopy revealed growth of a vegetative mass in the mucosa and it was not possible to reach the stomach. A nasogastric feeding tube was inserted at this moment. Again biopsies were taken and the results showed no malignancy.
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