Carcinoma cuniculatum is a rare low-grade well-differentiated squamous cell carcinoma, located mainly on lower limb and essentially on the plantar region (89%). It is the prerogative of the older male. Its pathogenesis remains unknown. Clinical features are suggestive of carcinoma cuniculatum, but histological confirmation often requires multiple deep biopsies namely histological examination of the surgical specimen. The main differential diagnosis is plantar wart. Surgical excision is the treatment of choice no recurrence was described after complete resection. The prognosis is mainly related to locoregional extension. We report the case of a 50-year-old patient with no particular past medical history, presentig with a vegetative tumor of the right heel, arising from a manipulated and self-medicated plantar wart, evolving from the age of 15 years in a context of maintenance of heath condition. Clinical examination revealed exophytic, painful, and bleeding heel budding tumor with regular shape, measuring 10 cm on the major axis. It is associated with bilateral plantar warts, with no significant adenopathies. An initial skin biopsy was in favor of a common wart. Complete resection of the lesion was performed. Anatomopathological examination of the surgical specimen was in favor of a well-differentiated squamous cell carcinoma. The evaluation of the extent of loco-regional recurrence and distant metastasis was negative. The covering of the right heel with a skin flap and an adequate medical treatment of the other plantar warts were recommended.
Pan African Medical Journal 2016; 24