Proliferative Verrucous Leukoplakia: Literature Review With Emphasis on Diagnosis, Manegement and Treatmen Leucoplasia Verrucosa Proliferativa: Revisão da Literartura com Ênfase no Diagnóstico, Manejo e Tratamento
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Published:
May 12, 2021
Keywords:
Oral leukoplakia, Oral cancer, Squamous cell carcinoma, Oral lichen planus, Erythroplasia
Main Article Content
Abstract
Oral Potentially Malignant Disorders (OPMDs) describe a group of diseases at increased risk of leading to Squamous Cell Carcinoma (SCC). The most common is Oral Leukoplakia (OL), which presents itself through an aggressive variant known as Proliferative Verrucous Leukoplakia (PVL). First described in 1985 by Hansen et al., PVL is considered an uncommon multifocal form of the disease, with an aggressive and relentless clinical course towards malignancy, and lacks association with traditional OL risk factors. The diagnosis and management of this disease form posits a significant challenge since, in addition to the absence of proven biomarkers that can predict its evolutionary course, the subjectivity existing in its clinical and histopathological evaluation means that the presence or degree of Oral Epithelial Dysplasia (OED) is not enough to determine whether or not the lesion will undergo a malignant transformation. The objective of this work was to carry out a Traditional Literature Review focused specifically on aspects of diagnosis, malignant transformation, management and treatment of PVL, an aggressive variant of OL. Our conclusion is that, to this day, there are no biomarkers able to predict the progress of OL, making it necessary to monitor and/or treat all OL cases, including cases of Keratosis of unknown significance.
Article Details
How to Cite
Barbosa de Azevedo, A. (2021). Proliferative Verrucous Leukoplakia: Literature Review With Emphasis on Diagnosis, Manegement and Treatmen. Naval Dental Jounal, 48(I), 56-63. https://doi.org/10.29327/25149.48.1-7
Section
Literature Reviews
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Classifications and clinical relevance in risk assessment of oral
potentially malignant disorders. J Oral Maxillofac Pathol. 2019
Jan-Apr;23(1):19-27.
24. Li CC, Almazrooa S, Carvo I, Salcines A, Woo SB.
Architectural Alterations in Oral Epithelial Dysplasia are
Similar in Unifocal and Proliferative Leukoplakia. Head Neck
Pathol. 2020 Sep 16.
25. Woo SB. Oral Epithelial Dysplasia and Premalignancy. Head
Neck Pathol. 2019 Sep;13(3):423-439.
26. Waldron CA, Shafer WG. Leukoplakia revisited. A
clinicopathologic study 3256 oral leukoplakias. Cancer. 1975
Oct;36(4):1386-92.
27. Müller S. Oral epithelial dysplasia, atypical verrucous
lesions and oral potentially malignant disorders: focus on
histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol.
2018 Jun;125(6):591–602.
28. Torrejon-Moya A, Jané-Salas E, López-López J. Clinical
manifestations of oral proliferative verrucous leukoplakia: A
systematic review. J Oral Pathol Med. 2020 May;49(5):404–408.
29. Tilakaratne WM, Jayasooriya PR, Jayasuriya NS, De Silva
RK. Oral epithelial dysplasia: Causes, quantification, prognosis,
and management challenges. Periodontol 2000. 2019
Jun;80(1):126-147.
30. Villa A, Menon RS, Kerr AR, De Abreu Alves F, Guollo A,
Ojeda D, et al. Proliferative leukoplakia: Proposed new clinical
diagnostic criteria. Oral Dis. 2018 Jul;24(5):749–60.
31. Napier SS, Speight PM. Natural history of potentially
malignant oral lesions and conditions: an overview of the
literature. J Oral Pathol Med. 2008 Jan;37(1):1-10.
32. Fitzpatrick SG, Honda KS, Sattar A, Hirsch SA. Histologic
lichenoid features in oral dysplasia and squamous cell
carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014
Apr;117(4):511–20.
33. Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.
Optimal Management of Proliferative Verrucous Leukoplakia:
A Systematic Review of the Literature. Otolaryngol Head
Neck Surg. 2015 Oct;153(4):504-11.
34. Farah CS, Fox SA. Dysplastic oral leukoplakia is molecularly
distinct from leukoplakia without dysplasia. Oral Dis. 2019
Oct;25(7):1715-1723.
35. Villa A, Hanna GJ, Kacew A, Frustino J, Hammerman PS, Woo
SB. Oral keratosis of unknown significance shares genomic
overlap with oral dysplasia. Oral Dis. 2019 Oct;25(7):1707-
1714.
36. Silverman S Jr, Gorsky M, Lozada F. Oral leukoplakia and
malignant transformation. A follow-up study of 257 patients.
Cancer. 1984 Feb 1;53(3):563-8.
37. Hsue SS, Wang WC, Chen CH, Lin CC, Chen YK, Lin LM.
Malignant transformation in 1458 patients with potentially
malignant oral mucosal disorders: a follow-up study based in
a Taiwanese hospital. J Oral Pathol Med. 2007 Jan;36(1):25-9.
38. Mehanna HM, Rattay T, Smith J, McConkey CC. Treatment
and follow-up of oral dysplasia - a systematic review and metaanalysis.
Head Neck. 2009 Dec;31(12):1600-9.
39. Brouns E, Baart J, Karagozoglu K, Aartman I, Bloemena E,
van der Waal I. Malignant transformation of oral leukoplakia
in a welldefined cohort of 144 patients. Oral Dis. 2014
Apr;20(3):e19–24.
40. Bagan JV, Jiménez-Soriano Y, Diaz-Fernandez JM, Murillo-
Cortés J, Sanchis-Bielsa JM, Poveda-Roda R, et al. Malignant
transformation of proliferative verrucous leukoplakia to oral
squamous cell carcinoma: a series of 55 cases. Oral Oncol.
2011 Aug;47(8):732-5.
Today. Lyon, France: International Agency for Research on
Cancer. [publicação na web]; 2018 (acesso em 07 out 2020).
Disponível em: https://gco.iarc.fr/today
2. Villa A, Villa C, Abati S. Oral cancer and oral erythroplakia:
an update and implication for clinicians. Aust Dent J. 2011
Sep;56(3):253-6.
3. Dost F, Lê Cao KA, Ford PJ, Farah CS. A retrospective analysis
of clinical features of oral malignant and potentially malignant
disorders with and without oral epithelial dysplasia. Oral Surg
Oral Med Oral Pathol Oral Radiol. 2013 Dec;116(6):725-33.
4. Ganesh D, Sreenivasan P, Öhman J, Wallström M, Braz-Silva
PH, Giglio D, et al. Potentially Malignant Oral Disorders and
Cancer Transformation. Anticancer Res. 2018 Jun;38(6):3223-
3229.
5. Mello FW, Miguel AFP, Dutra KL, Porporatti AL,
Warnakulasuriya S, Guerra ENS, et al. Prevalence of oral
potentially malignant disorders: A systematic review and metaanalysis.
J Oral Pathol Med. 2018 Aug;47(7):633-640.6. Nikitakis NG, Pentenero M, Georgaki M, Poh CF, Peterson
DE, Edwards P, et al. Molecular markers associated with
development and progression of potentially premalignant oral
epithelial lesions: Current knowledge and future implications.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018
Jun;125(6):650-669.
7. Woo SB, Grammer RL, Lerman MA. Keratosis of unknown
significance and leukoplakia: a preliminary study. Oral Surg
Oral Med Oral Pathol Oral Radiol. 2014 Dec;118(6):713–24.
8. Warnakulasuriya S, Kovacevic T, Madden P, Coupland VH,
Sperandio M, Odell E, et al. Factors predicting malignant
transformation in oral potentially malignant disorders among
patients accrued over a 10-year period in South East England.
J Oral Pathol Med. 2011 Oct;40(9):677-83.
9. Speight PM, Khurram SA, Kujan O. Oral potentially malignant
disorders: risk of progression to malignancy. Oral Surg Oral
Med Oral Pathol Oral Radiol. 2018 Jun;125(6):612-627.
10. Warnakulasuriya S, Ariyawardana A. Malignant transformation
of oral leukoplakia: a systematic review of observational studies.
J Oral Pathol Med. 2016 Mar;45(3):155-66.
11. Soares AB, Perschbacher K, Perez-Ordonez B. Oral
potentially malignant disorders. Mini-Symposium: Head
And Neck Pathology. Diagnostic Histopathology. 2018
May;24(5):161-65.
12. Van der Waal I. Historical perspective and nomenclature of
potentially malignant or potentially premalignant oral epithelial
lesions with emphasis on leukoplakia-some suggestions for
modifications. Oral Surg Oral Med Oral Pathol Oral Radiol.
2018 Jun;125(6):577-581.
13. Hansen LS, Olson JA, Silverman S Jr. Proliferative verrucous
leukoplakia. A long-term study of thirty patients. Oral Surg
Oral Med Oral Pathol. 1985 Sep;60(3):285-98.
14. Dost F, Lê Cao K, Ford PJ, Ades C, Farah CS. Malignant
transformation of oral epithelial dysplasia: a real-world
evaluation of histopathologic grading. Oral Surg Oral Med
Oral Pathol Oral Radiol. 2014 Mar;117(3):343-52.
15. Van der Waal I. Potentially malignant disorders of the oral
and oropharyngeal mucosa; present concepts of management.
Oral Oncol. 2010 Jun;46(6):423-5.
16. Celentano A, Glurich I, Borgnakke WS, Farah CS. World
Workshop on Oral Medicine VII: Prognostic biomarkers in
oral leukoplakia and proliferative verrucous leukoplakia—A
systematic review of retrospective studies. Oral Dis.
2020;00:1–33.
17. Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition
of leukoplakia and related lesions: an aid to studies on
oral precancer. Oral Surg Oral Med Oral Pathol. 1978
Oct;46(4):518-39.
18. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ
(Eds): WHO Classification of Head and Neck Tumours (4th
edition). IARC: Lyon 2017. p. 112–5.
Revista N aval de Odontologia - 2021 - Volume 48 Número 1 63
19. Villa A, Gohel A. Oral potentially malignant disorders
in a large dental population. J Appl Oral Sci. 2014 Nov-
Dec;22(6):473-6.
20. Awadallah M, Idle M, Patel K, Kademani D. Management update
of potentially premalignant oral epithelial lesions. Oral Surg
Oral Med Oral Pathol Oral Radiol. 2018 Jun;125(6):628-636.
21. Lingen MW, Pinto A, Mendes RA, Franchini R, Czerninski
R, Tilakaratne WM, et al. Genetics/epigenetics of oral
premalignancy: current status and future research. Oral Dis.
2011 Apr;17 Suppl 1:7-22.
22. Arduino PG, Bagan J, El-Naggar AK, Carrozzo M. Urban legends
series: oral leukoplakia. Oral Dis. 2013 Oct;19(7):642-59.
23. Ranganathan K, Kavitha L. Oral epithelial dysplasia:
Classifications and clinical relevance in risk assessment of oral
potentially malignant disorders. J Oral Maxillofac Pathol. 2019
Jan-Apr;23(1):19-27.
24. Li CC, Almazrooa S, Carvo I, Salcines A, Woo SB.
Architectural Alterations in Oral Epithelial Dysplasia are
Similar in Unifocal and Proliferative Leukoplakia. Head Neck
Pathol. 2020 Sep 16.
25. Woo SB. Oral Epithelial Dysplasia and Premalignancy. Head
Neck Pathol. 2019 Sep;13(3):423-439.
26. Waldron CA, Shafer WG. Leukoplakia revisited. A
clinicopathologic study 3256 oral leukoplakias. Cancer. 1975
Oct;36(4):1386-92.
27. Müller S. Oral epithelial dysplasia, atypical verrucous
lesions and oral potentially malignant disorders: focus on
histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol.
2018 Jun;125(6):591–602.
28. Torrejon-Moya A, Jané-Salas E, López-López J. Clinical
manifestations of oral proliferative verrucous leukoplakia: A
systematic review. J Oral Pathol Med. 2020 May;49(5):404–408.
29. Tilakaratne WM, Jayasooriya PR, Jayasuriya NS, De Silva
RK. Oral epithelial dysplasia: Causes, quantification, prognosis,
and management challenges. Periodontol 2000. 2019
Jun;80(1):126-147.
30. Villa A, Menon RS, Kerr AR, De Abreu Alves F, Guollo A,
Ojeda D, et al. Proliferative leukoplakia: Proposed new clinical
diagnostic criteria. Oral Dis. 2018 Jul;24(5):749–60.
31. Napier SS, Speight PM. Natural history of potentially
malignant oral lesions and conditions: an overview of the
literature. J Oral Pathol Med. 2008 Jan;37(1):1-10.
32. Fitzpatrick SG, Honda KS, Sattar A, Hirsch SA. Histologic
lichenoid features in oral dysplasia and squamous cell
carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014
Apr;117(4):511–20.
33. Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.
Optimal Management of Proliferative Verrucous Leukoplakia:
A Systematic Review of the Literature. Otolaryngol Head
Neck Surg. 2015 Oct;153(4):504-11.
34. Farah CS, Fox SA. Dysplastic oral leukoplakia is molecularly
distinct from leukoplakia without dysplasia. Oral Dis. 2019
Oct;25(7):1715-1723.
35. Villa A, Hanna GJ, Kacew A, Frustino J, Hammerman PS, Woo
SB. Oral keratosis of unknown significance shares genomic
overlap with oral dysplasia. Oral Dis. 2019 Oct;25(7):1707-
1714.
36. Silverman S Jr, Gorsky M, Lozada F. Oral leukoplakia and
malignant transformation. A follow-up study of 257 patients.
Cancer. 1984 Feb 1;53(3):563-8.
37. Hsue SS, Wang WC, Chen CH, Lin CC, Chen YK, Lin LM.
Malignant transformation in 1458 patients with potentially
malignant oral mucosal disorders: a follow-up study based in
a Taiwanese hospital. J Oral Pathol Med. 2007 Jan;36(1):25-9.
38. Mehanna HM, Rattay T, Smith J, McConkey CC. Treatment
and follow-up of oral dysplasia - a systematic review and metaanalysis.
Head Neck. 2009 Dec;31(12):1600-9.
39. Brouns E, Baart J, Karagozoglu K, Aartman I, Bloemena E,
van der Waal I. Malignant transformation of oral leukoplakia
in a welldefined cohort of 144 patients. Oral Dis. 2014
Apr;20(3):e19–24.
40. Bagan JV, Jiménez-Soriano Y, Diaz-Fernandez JM, Murillo-
Cortés J, Sanchis-Bielsa JM, Poveda-Roda R, et al. Malignant
transformation of proliferative verrucous leukoplakia to oral
squamous cell carcinoma: a series of 55 cases. Oral Oncol.
2011 Aug;47(8):732-5.