Verrucous hyperplasia is a pre-neoplastic lesion that inevitably progresses to verrucous carcinoma or squamous cell carcinoma. Diagnosis is histological; this lesion may exist alone or as part of the spectrum of lesions described in verrucous leukoplakia. The distinction is based on the endophytic and exophytic growth aspects of the epithelial proliferation: In verrucous carcinoma, in addition to surface projections, there are also extensions of the lesion into the underlying connective tissue that are not found in hyperplasia.
A 63-year-old patient, followed up for pancreatic head tumor with hepatic metastasis, presented to the dermatology department with a vegetative lesion on the lower lip. Physical examination revealed an exophytic, well-limited, verrucous tumor on the lower lip (Figure 1). On the basis of the clinical and histological findings, the diagnosis of verrucous epidermal hyperplasia was made. The patient was referred to the maxillofacial department for treatment.