Differential diagnosis includes verrucous hyperplasia, well-differentiated SCC, papillary SCC, and squamous papilloma.
Invasion below the level of the basal cell layer of the neighbouring normal squamous epithelium distinguishes VC from verrucous hyperplasia. Whether this feature, however, adequately discriminates between VC and ver-rucous hyperplasia is debatable, as verrucous hyperpla-sia could be an exophytic form of VC as well .
Lack of atypia helps to rule out the conventional SCC and papillary SCC. The VC also lacks the well-formed, wide papillary fronds of a squamous cell papilloma.
An additional feature supporting the diagnosis of a VC is the enlarged spinous cells by morphometrical analysis .
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