ORAL PROLIFERATIVE VERRUCOUS LEUKOPLAKIA: A LONG-TERM CLINICAL, CYTOPATHOLOGIC, AND HISTOPATHOLOGIC FOLLOW-UP

Proliferative verrucous leukoplakia (PVL) is an aggressive form of leukoplakia, which affects multiple oral sites, with high probability of recurrence and a high rate of malignant transformation. Clinically it may present as a homogeneous white plaque or leukoeritroplakia, with an exophytic or verrucous surface. We report a case with 8 years of follow-up of an 85-year-old woman with white plaques on the left buccal mucosa, inferior alveolar mucosa, floor of the mouth, and lateral border of the tongue. Combined cytopathologic and histopathologic examination was performed over 6 years, showing initially mild dysplasia and keratosis, which progressed to moderate and severe dysplasia. After 6 years of follow-up evaluation, an upper alveolar mucosa lesion was diagnosed as an in situ carcinoma. The patient was referred for treatment, and a surgical resection was performed. The patient is currently being monitored and evaluated with periodic cytopathologic exams.