Background: Verrucous carcinoma is a rare, well-differentiated variant of squamous cell carcinoma that most commonly arises on acral and mucosal surfaces. Its indolent course and subtle histological atypia often lead to diagnostic challenges.
Case Presentation: We report a 63-year-old Filipino male with a four-year history of a progressively enlarging verrucous plaque on the plantar surface of the left foot. Initial superficial biopsy revealed verruca plantaris, but a subsequent deep incisional biopsy confirmed verrucous carcinoma with underlying verruca plantaris. The patient underwent a wide local excision with histologically clear margins. Postoperative recovery was uneventful, and complete epithelialization was achieved, resulting in a satisfactory functional outcome.
Conclusions: This case highlights the diagnostic challenges of plantar verrucous carcinoma, which is often misdiagnosed as benign verruca vulgaris. Adequate deep tissue sampling and early surgical intervention are essential to prevent progressive local destruction and reduce the risk of amputation.