Flexible endoscopic approach to verrucous carcinoma of the larynx.

This is a difficult task, due to the thick keratin layer on the tumour surface and hard tumour consistency, and requires a special effort from the clinician, which usually is not necessary in case of biopsy of papilloma or typical SCC. Diagnosis is difficult because the tumour appears macroscopically "malignant" and microscopically "benign".5 The presence of the thick layer of keratin on the tumour surface creates major obstacles for obtaining an adequate biopsy material, which frequently results in inadequate traditional biopsy and inconclusive histologic response. In order to obtain an adequate biopsy specimen for histologic confirmation of the nature of tumour, flexible endoscopic snare diathermy excision under local anaesthesia with lidocaine 2% was used. [Extracted from the article]