Invasive verrucous carcinoma Well-differentiated exophytic squamous cell carcinoma with an undulating hyperkeratinized surface composed of papillary projections that lack central fibrovascular cores (useful to distinguish this lesion from a condyloma acuminatum) invading the underlying stroma in the form of bulbous pegs with a pushing border. This carcinoma demonstrates almost no cytonuclear atypia. This diagnosis may be difficult on small biopsies. Histopathology atlas |