Verruca vulgaris of the larynx: a distinctive lesion of probable viral origin confused with verrucous carcinoma.

Two adult males had superficial, keratotic vocal cord lesions. One was diagnosed as verrucous carcinoma, prompting a hemilaryngectomy. The other was interpreted as a squamous papilloma and was treated by local excision. Both patients are disease-free 7 years and 18 months, respectively, following surgery. The histologic features of both lesions are identical to those of cutaneous verruca vulgaris, and immunoperoxidase staining for human papilloma virus was positive in one case. Laryngeal verruca vulgaris has not been previously described and in the past may have been misdiagnosed as verrucous carcinoma, leading to unnecessary surgery. The histologic features of laryngeal verruca vulgaris are presented and its distinction from other cytologically bland, keratotic lesions of the larynx is discussed.