Uncommon location of verrucous carcinoma

Verrucous carcinoma is an uncommon locally invasive slow growing squamous cell carcinoma of the skin and mucous membrane. It usually appears as a raised, fungating, white cauliflower-like mass. It usually occurs in oral cavity followed by genital region. Human papillomavirus, betel nut chewing, alcohol consumption, and schistosomiasis are the accepted causes for verrucous carcinoma. The recommended treatment is wide local excision with a negative margin. Even after wide local excision, local recurrence is very high compared to squamous cell carcinoma. Until now, only one case was reported with presternal verrucous carcinoma which is a rare occurrence