IADR Abstract Archives
A STUDY OF THE VARIETY OF POSSIBLE HISTOPATHOLOGICAL DIAGNOSES OF CLINICALLY VERRUCOUS ORAL LESIONS
Objectives: To study the variety of oral pathologies presenting clinically with verrucous features.
Methods: 10-year retrospective study (2007 to 2016) of oral verrucous lesions was undertaken. All biopsies which included a clinical description of papillary or verrucous architecture were retrieved. The data collected included clinical features, size, color, location, histopathological diagnosis age and gender.
Results: The study included 137 patients, with a total of 151 lesions. The ages ranged from 10 weeks to 84 years (mean 49). Histopathologically, 60% of cases were HPV related, 19% showed hyperplasia, 11% hyperplastic candidiasis, 7% dysplasia or malignancy and 3% other. Of the 7% diagnosed with dysplasia or malignancy, only 60% were suspected for malignancy at the time of biopsy.
HPV-related lesions and hyperplasia were most frequently found on the tongue (38% and 41%) and soft palate (21% and 14%) respectively. Hyperplastic candidiasis was most frequent on the buccal mucosa and tongue (35% and 24% respectively).
1.3% of total lesions were found to be squamous cell carcinoma (SCC) and 1.3% verrucous carcinoma. 50% of the verrucous/papillary malignant lesions were found on the gingiva. Most malignant lesions occurred in the 40-60 age group.
Conclusions: The results of this study suggest, that due to the wide spectrum of entities presenting clinically as papillary-verrucous architecture, biopsy is necessary for diagnosis. It is of significant importance to correctly identify those lesions which are HPV-related, but at the same time to rule-out those lesions which are unrelated to HPV, to help alleviate patients' anxiety. The clinical presentations allowed for overall accurate diagnosis in only 47% of cases and 60% accuracy in dysplastic or malignant cases. Most importantly, biopsy is mandatory for recognition of the malignant lesions with a papillary verrucous architecture, which may mimic other benign entities in the group of papillary verrucous lesions.
Methods: 10-year retrospective study (2007 to 2016) of oral verrucous lesions was undertaken. All biopsies which included a clinical description of papillary or verrucous architecture were retrieved. The data collected included clinical features, size, color, location, histopathological diagnosis age and gender.
Results: The study included 137 patients, with a total of 151 lesions. The ages ranged from 10 weeks to 84 years (mean 49). Histopathologically, 60% of cases were HPV related, 19% showed hyperplasia, 11% hyperplastic candidiasis, 7% dysplasia or malignancy and 3% other. Of the 7% diagnosed with dysplasia or malignancy, only 60% were suspected for malignancy at the time of biopsy.
HPV-related lesions and hyperplasia were most frequently found on the tongue (38% and 41%) and soft palate (21% and 14%) respectively. Hyperplastic candidiasis was most frequent on the buccal mucosa and tongue (35% and 24% respectively).
1.3% of total lesions were found to be squamous cell carcinoma (SCC) and 1.3% verrucous carcinoma. 50% of the verrucous/papillary malignant lesions were found on the gingiva. Most malignant lesions occurred in the 40-60 age group.
Conclusions: The results of this study suggest, that due to the wide spectrum of entities presenting clinically as papillary-verrucous architecture, biopsy is necessary for diagnosis. It is of significant importance to correctly identify those lesions which are HPV-related, but at the same time to rule-out those lesions which are unrelated to HPV, to help alleviate patients' anxiety. The clinical presentations allowed for overall accurate diagnosis in only 47% of cases and 60% accuracy in dysplastic or malignant cases. Most importantly, biopsy is mandatory for recognition of the malignant lesions with a papillary verrucous architecture, which may mimic other benign entities in the group of papillary verrucous lesions.
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