Oral verrucous hyperplasia: histologic classification, prognosis, and clinical implications
Article first published online: 27 JUL 2009
© 2009 John Wiley & Sons A/S
Journal of Oral Pathology & Medicine
Volume 38, Issue 8, pages 651–656, September 2009
How to Cite
Wang, Y.-P., Chen, H.-M., Kuo, R.-C., Yu, C.-H., Sun, A., Liu, B.-Y., Kuo, Y.-S. and Chiang, C.-P. (2009), Oral verrucous hyperplasia: histologic classification, prognosis, and clinical implications. Journal of Oral Pathology & Medicine, 38: 651–656. doi: 10.1111/j.1600-0714.2009.00790.x
- Issue published online: 1 SEP 2009
- Article first published online: 27 JUL 2009
- Accepted for publication April 14, 2009
- clinical implications;
- malignant transformation;
- oral cancer;
- oral verruciform leukoplakia;
- oral verrucous hyperplasia
Background: Oral verrucous hyperplasia (OVH) is a premalignant lesion that may transform into an oral cancer.
Methods: Sixty consecutive OVH cases were collected from 2003 to 2004. Clinicopathological features and the 5-year malignant transformation rate of these 60 OVH lesions were evaluated and analyzed.
Results: We found that 84% of OVH lesions occurred in patients between 40 and 69 years of age. The most common site for OVH lesions was the buccal mucosa (48%), followed by the tongue (20%), palate (18%), gingiva (7%), and labial mucosa (7%). Approximately 91% of OVH patients were areca quid chewers and 89% were smokers. When 60 OVH lesions were classified into 30 plaque-typed and 30 mass-typed OVH lesions, the mass-typed OVH lesions had a higher malignant transformation rate of 17% (5/30) than the plaque-typed OVH lesions (3%, 1/30) during a mean follow-up period of 59 ± 7 months. The mean time for malignant transformation was 22 ± 11 months. Of the 6 OVH lesions with malignant transformation, 2 underwent total surgical excision and 4 did not receive any form of therapy.
Conclusions: We conclude that OVH lesions occur more commonly on the buccal mucosa and are highly associated with the areca quid chewing and cigarette smoking habits. The overall 5-year malignant transformation rate of 60 OVH lesions was 10%. The mass-typed OVH lesions had a higher malignant transformation rate than the plaque-typed OVH lesions and thus should receive an immediate treatment, such as total surgical excision or photodynamic therapy, after the histopathologic diagnosis.