Dermatopathology in historical perspective: epithelioma cuniculatum (Aird)

Professor Ian Aird, a renowned British surgeon of the mid-twentieth century, described a peculiar neoplasm of the foot in 3 patients under the term epithelioma cuniculatum, now more commonly called carcinoma cuniculatum. I will recount the life of Professor Aird and then summarize his original report emphasizing the clinical and more particularly the histopathologic criteria of epithelioma cuniculatum as described by Aird et al. Then I will summarize some of the subsequent reports of epithelioma (carcinoma) cuniculatum. Authors have grouped carcinoma cuniculatum with giant condyloma of the penis of Buschke-Loewenstein and oral verrucous carcinoma of Ackerman and similar neoplasms at other sites under the generic title "verrucous carcinoma." Although this classification has been accepted, I will stress that the clinical picture and histopathology described by Aird et al differ from those in later reports of carcinoma cuniculatum. These correspond to descriptions of the verrucous carcinomas of Buschke-Loewenstein and Ackerman. Finally, I will conclude that carcinoma cuniculatum as delineated by Aird and his colleagues is an extremely rare, indolent, nonmetastasizing squamous cell carcinoma composed of banal keratinocytes with unique clinical and histopathologic features that almost always arises on the foot. If a neoplasm on the foot has the characteristics of verrucous carcinoma that occurs at others sites, but not those of Aird et al, it should be called verrucous carcinoma of the foot, and not "epithelioma (carcinoma) cuniculatum."