Proliferative verrucous leukoplakia: a clinicopathological comparative study |
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| Institution: | 1. Department of Otorhinolaryngology, Rabin Medical Center, Petah-Tikva, Israel;2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel;3. Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petah-Tikva, Israel;4. Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel;5. Institute of Pathology, Rabin Medical Center, Petah-Tikva, Israel;1. Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK;2. School of Medicine, Medical and Biological Sciences, North Haugh, St Andrews, UK;3. Astraglobe Ltd, Congleton, Cheshire;4. Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK;5. Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK;1. Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA;2. Orthodontics of Dental Corps, The United States Air Force, USA;3. Department of Oral and Maxillofacial Surgery, Houston Methodist, Houston, TX, USA;4. Department of Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY, USA;1. Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Aichi, Japan;2. Department of Oral and Maxillofacial Surgery, Toyota Wakatake Hospital, Aichi, Japan;1. Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan;2. Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan |
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| Abstract: | A retrospective clinicopathological analysis was performed to compare 35 proliferative verrucous leukoplakia (PVL), 40 leukoplakia without dysplasia (LK), 48 oral lichen planus (OLP)/oral lichenoid lesions (OLL), and 11 verrucous carcinoma (VC) (N = 134). The PVL group comprised 24 female and 11 male patients (mean age 66.5 years), with two to six sites involved (mean 3.1 sites) and multiple biopsies over time (mean 7.1/case). All PVL cases developed malignancy: 77.1% squamous cell and 40% verrucous carcinoma; 68.6% had multiple sites of malignancy. None showed local or distant metastatic spread. Five-year disease-specific survival was 88.6%. In LK and OLP/OLL, malignant transformation was significantly lower than in PVL (2.5% and 2.1%, respectively). Invasive squamous cell carcinoma was not reported in any conventional VC. Immunohistochemical histomorphometric analysis for p53, COX-2, and podoplanin showed no significant differences between the groups. PVL may overlap with LK, OLP/OLL, and VC, but has a persistent aggressive behaviour and high malignant transformation rate. The overlapping features may delay recognition as PVL. The results emphasize the need for a detailed clinicopathological definition of PVL, and long-term close monitoring to ensure progression to PVL and malignancy are recognized in time. The management of this persistent aggressive condition is challenging. |
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| Keywords: | leukoplakia lichen planus hyperplasia squamous carcinoma verrucous carcinoma |
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