Subset of patients with verrucous carcinoma of the oral cavity benefit from treatment with methotrexate

Oral verrucous carcinoma (OVC) is a low-grade variant of squamous cell carcinoma (SCC) with a distinctive morphology and specific pattern of behaviour that is often diagnosed in elderly patients. Resection is the treatment of choice, with radiotherapy as a reasonable alternative. In this retrospective case review we present our experience and outcomes in a group of 12 patients with various stages of OVC who had not been treated conventionally because of the extent of their lesions and their poor general condition. All patients were given chemotherapy with methotrexate, which was given by various routes and in different doses during the period 1972-2010. In 11 patients treatment with methotrexate alone was beneficial. One patient failed to respond. Methotrexate used alone as chemotherapy may minimise morbidity and improve quality of life, particularly among elderly patients.