Summary
The proliferative verrucous leukoplakia (PVL) is a white plate, wart-like, exophytic, slow growth, which does not follow the scaling that tends to compromise various oral mucosal sites . It is resistent to independent therapy and has a high rate of recurrence after surgical treatment. Since 1985, when it was first described by Hansen, and to date it has remained a complex pathological disorder. We report a case of a 72-year-old female patient who complains of a white, verrucous and asymptomatic lesion. The lesion does not detach by scraping the edge, lingual belly or mouth floor. Two Incisional biopsies were performed on lateral border of the tongue. Upon microscopic examination of both biopsies, thick epithelial lining, with marked hyperparakeratosis, a basement membrane, and minimal dysplasia alterations were observed. One month following biopsies of the lesion were performed, lesion relapsed and maintained the same clinical features found initially. Considering the evolution, biological behavior and histopathological features, the lesion is diagnosed as an PVL. To date, there is no established treatment protocol for these injuries. In this particular case, taking into account the extent of the injury, compromised sites, the few atypia present histopathological examination, age and low socioeconomic level of the patient, it was decided not to perform surgical removal of the lesion and maintain clinical monitoring every 3 months. Following several examinations carried out over a three-year period, it was observed that the injury kept initial clinical features. This confirms that having opted for conservative treatment, in this particular case of PVL, was the right decision. However, it is important to consider that, as reported in the literature, there is a high and unpredictable rate of malignant transformation. Therefore periodic clinical controls are vital for early diagnosis of cell carcinoma or verrucous carcinoma.
KEY WORDS: proliferative verrucous leukoplakia, oral leukoplakia, oral pathology.
How to cite this article
FERNÁNDEZ, M. A.; MARSHALL, M. & ESGUEP, S. A. Proliferative Verrucous Leukoplakia: a clinical case. Int. J. Odontostomat., 7(3):379-383, 2013.
