Cutaneous horn arising from the nasal vestibule is an extremely rare entity with only four published case reports to date. Although cutaneous horns are commonly benign, the risk of it harbouring a malignant or pre-malignant process is about 1 in 3. Verrucous carcinoma is a variant of squamous cell carcinoma that typically presents the oral cavity, and very rarely in the nasal cavity. We report a 78-year-old female who presented with a rapidly enlarging right naris cutaneous horn of 5 months

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... tion. CT scan showed a heterogeneously enhancing mass at the right anterior nasal cavity with no overt bone or cartilage destruction. Differential diagnoses included seborrheic keratosis, actinic keratosis, viral wart and malignant tumour such as squamous cell carcinoma. She underwent an excision biopsy and histology confirmed the diagnosis of a pT1 verrucous squamous cell carcinoma. Due to the rarity of the site of disease, management of sinonasal verrucous carcinoma is generally derived from management options of other subsites in the head and neck region. The preferred treatment modality is surgical excision, while primary radiotherapy is an emerging treatment alternative in poor surgical candidates.