Classificatory updates in verrucous and cuniculatum carcinomas - Insights from the 5th edition of WHO-IARC head and neck tumor classification

Sep 21, 2026

The International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) jointly develop the WHO Blue Books that standardize diagnostic practice for human cancers. The 5th edition of the WHO/IARC classification for head and neck tumors revises the “Oral Cavity and Mobile Tongue” chapter, reorganizing epithelial tumors by tumor behavior and adding categories relevant to uncertain histogenesis. Emphasis is placed on verrucous carcinoma and carcinoma cuniculatum, highlighting their clinical and histologic distinctiveness, epidemiology, pathogenesis, and prognostic factors to improve detailed, subtype-focused diagnostic understanding.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages5

Reading Time13 min

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Editorial

Classificatory updates and WHO/IARC 5th edition revisions

Specific sections for verrucous carcinoma and carcinoma cuniculatum

Clinical relevance and implications for diagnosis

| W | J | C | O | World Journal of
Clinical Oncology | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Oncol 2024 April 24; 15(4): 464-467 DOI: 10.5306/wjco.v15.i4.464 ISSN 2218-4333 (online) EDITORIAL Classificatory updates in verrucous and cuniculatum carcinomas: Insights from the 5th edition of WHO-IARC head and neck tumor classification Felipe Martins Silveira, Lauren Frenzel Schuch, Ronell Bologna-Molina Specialty type: Pathology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s scientific quality classification Grade A (Excellent): 0 Grade B (Very good): B Grade C (Good): 0 Grade D (Fair): 0 Grade E (Poor): 0 P-Reviewer: Datar UV, India Received: December 9, 2023 Peer-review started: December 9, 2023 First decision: January 28, 2024 Revised: February 2, 2024 Accepted: March 20, 2024 Article in press: March 20, 2024 Published online: April 24, 2024 Felipe Martins Silveira, Lauren Frenzel Schuch, Ronell Bologna-Molina, Department of Diagnostics in Oral Pathology and Oral Medicine, Faculty of Dentistry, Universidad de la República, Montevideo 1600, Uruguay Ronell Bologna-Molina, Department of Oral Pathology, Universidad Juarez del Estado de Durango, Durango 13400, Mexico Corresponding author: Ronell Bologna-Molina, DDS, MSc, PhD, Professor, Department of Diagnostics in Oral Pathology and Oral Medicine, Faculty of Dentistry, Universidad de la República, Montevideo 1600, [Uruguay.](Uruguay. ronellbologna@hotmail.com)[ ronellbologna@hotmail.com](Uruguay. ronellbologna@hotmail.com) Abstract The International Agency for Research on Cancer (IARC) and World Health Organization (WHO) collaboratively produce the 'WHO Blue Books' essential tools standardizing the diagnostic process for human cancers. Regular updates in this classification accommodate emerging molecular discoveries, advances in immunohistochemical techniques, and evolving clinical insights. The 5th edition of the WHO/IARC classification of head and neck tumors refines the 'Oral Cavity and Mobile Tongue' chapter, including sections for non-neoplastic lesions, epithelial tumors, and tumors of uncertain histogenesis. Notably, the epithelial tumors section is rearranged by tumor behavior, starting with benign squamouspapillomas and progressing through potentially malignant oral disorders to oralsquamous cell carcinoma (OSCC) . The section on OSCC reflects recent information on epidemiology, pathogenesis, and histological prognostic factors. Noteworthy is the specific categorization of verrucous carcinoma (VC) and carcinoma cuniculatum (CC), both associated with the oral cavity and distinct in clinical and histologic characteristics. This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck. Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes, elucidating their clinical features, distinct histological characteristics, prevalence, significance, and clinical relevance. By categorizing these subtypes into specific sections, the 5th edition of the WHO classification aims to provide a more nuanced and detailed account, enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors. Key Words: World Health Organization; Squamous cell carcinoma of head and neck; WJCO [https://www.wjgnet.com](https://www.wjgnet.com) 464 April 24, 2024 Volume 15 Issue 4 Silveira FM et al. Verrucous carcinoma and carcinoma cuniculatum classification Verrucous carcinoma; Mouth neoplasms ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved. Core Tip: The collaboration between the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) has produced indispensable 'W

FAQs

What is the purpose of the WHO Blue Books in cancer diagnosis?

They provide standardized diagnostic tools and nomenclature for human cancers, helping harmonize classification practices. Updates incorporate new molecular and immunohistochemical evidence and evolving clinical insights.

What changes does the 5th edition make to the “Oral Cavity and Mobile Tongue” chapter?

It refines the chapter structure by including sections for non-neoplastic lesions, epithelial tumors, and tumors of uncertain histogenesis. Epithelial tumors are rearranged according to tumor behavior.

Why are verrucous carcinoma and carcinoma cuniculatum given specific attention in the classification?

They are categorized into dedicated sections because they show distinct clinical and histologic characteristics and are associated predominantly with the oral cavity. The update aims to clarify their clinical features, histology, prevalence, and clinical relevance.

Sep 21, 2026

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