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Review
. 2017 Sep-Oct;83(5):585-593.
doi: 10.1016/j.bjorl.2016.12.005. Epub 2017 Jan 24.

Proliferative verrucous leukoplakia: diagnosis, management and current advances

Diogo Lenzi Capella  1 , Jussara Maria Gonçalves  1 , Adelino António Artur Abrantes  1 , Liliane Janete Grando  2 , Filipe Ivan Daniel  3
Affiliations
Review

Proliferative verrucous leukoplakia: diagnosis, management and current advances

Diogo Lenzi Capella et al. Braz J Otorhinolaryngol. 2017 Sep-Oct.

Abstract
in English, Portuguese

Introduction: Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. It is characterized by a high rate of oral squamous cell carcinoma and verrucou carcinoma transformations.

Objective: To analyze the studies about Proliferative verrucous leukoplakia and develop a concise update.

Methods: A Pubmed search identifying studies (laboratory research, case series and reviews of literature) that examined patients with Proliferative verrucous leukoplakia was realized.

Results: There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. Although several treatment strategies have been proposed, most of them still show a high recurrence rate.

Conclusion: More research about Proliferative verrucous leukoplakia is necessary to understand and treat this disease.

Introdução: Leucoplasia verrucosa proliferativa (LVP) é uma lesão multifocal e progressiva da mucosa oral, com etiologia desconhecida e comumente resistente a todas as tentativas terapêuticas, com recorrências frequentes. É caracterizada por uma alta taxa de transformação em carcinoma de células escamosas e carcinoma verrucoso da cavidade oral.

Objetivo: Analisar os estudos sobre LVP e elaborar uma atualização resumida.

Método: Foi realizada uma pesquisa na base de dados Pubmed identificando estudos (pesquisas laboratoriais, séries de casos e revisões de literatura) que avaliaram pacientes com LVP.

Resultados e discussão: Não há estudos suficientes sobre LVP na literatura. Os poucos estudos encontrados não apresentam consenso quanto aos critérios de etiologia e diagnóstico. Embora várias estratégias de tratamento tenham sido propostas, a maioria ainda apresenta alta taxa de recorrência.

Conclusão: Mais pesquisas sobre LVP são necessárias para entender e tratar esta doença.

Keywords: Carcinoma, Célula escamosa; Câncer de cabeça e pescoço; Câncer oral; Head and neck cancer; Leucoplasia; Leucoplasia oral; Leucoplasia verrucosa proliferativa; Leukoplakia; Leukoplakia oral; Oral cancer; Proliferative verrucous leukoplakia; Squamous cell carcinoma.

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Figures

Figure 1
Figure 1
(A) Proliferative verrucous leukoplakia (PVL) in the lower attached gingival, vestibular sulcus and gradually extended along left alveolar ridge. (B) PVL in the buccal mucosa with different clinical patterns: larger areas of homogeneous leukoplakias and spot areas of thickening of the keratinization and/verrucous surface. (C and D) PVL in ventral tongue and floor of mouth with exophytic appearance and focal area of granular pattern in both alveolar ridges. (E) Histopathological view showing acanthosis and hyperkeratosis with mild dyplasia. (F) Exophytic, hyperkeratotic lesion with prominent verruciform or papillary surface and acanthosis forming blunt projections into the lamina propria. (G) Hyperkeratosis, acanthosis, irregularity of the basal layer and some areas of epithelial atrophy. (H) Hyperkeratosis with droplet-shaped epithelial projections and intact lamina propria (HE, original magnification 40×).
Figure 2
Figure 2
Histologic stages of progression to carcinoma. Adapted from Ghazali et al. (2003).
See this image and copyright information in PMC

References

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