A case of verrucous carcinoma treated by 5% imiquimod cream

Verrucous carcinoma is a slow-growing, well-differentiated, low grade squamous cell carcinoma with little tendency to metastasize. The best treatment for verrucous carcinoma is excision, and Mohs microsurgery may also be a helpful technique. But some people can not undergo surgical excision because of poor general condition of the site and the size of the tumor. Herein, we report a case of verrucous carcinoma treated by 5% imiquimod cream. A 71-year-old male patient presented with a large hyperkeratotic verrucous plaque on the Rt. buttock. Diagnosis of verrucous carcinoma was based on typical clinical and histologic features. Surgical excision could not be performed due to me size of the tumor. Treatment with 5% imiquimod cream, a topical immune response modifier, applied every other day for 16 weeks, led to tumor regression. Four weeks after tibe end of treatment, the lesion was evaluated by punch biopsy. The histology just showed scar tissue change. This case demonstrates that the imiquimod cream might be an alternative treatment option for verrucous carcinoma.