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Caracterização clinicopatológica de uma série de casos de leucoplasia verrucosa proliferativa numa clínica universitária portuguesa
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Introdução: A leucoplasia verrucosa proliferativa (LVP) é uma alteração patológica da mucosa oral com elevado potencial de malignização. Caracteriza-se pela presença de múltiplas placas esbranquiçadas, não associadas a nenhum fator etiológico conhecido. O caráter multifocal, proliferativo e recidivante destas lesões dificulta o seu tratamento médico ou cirúrgico.
Objetivo: Realizar uma análise descritiva das características demográficas, clínicas e histológicas de uma série de oito casos clínicos de LVP.
Material e Métodos: Procedeu-se à consulta dos processos clínicos dos doentes com diagnóstico de LVP acompanhados no Departamento de Cirurgia e Medicina Oral da Faculdade de Medicina Dentária da Universidade de Lisboa nos últimos 10 anos. Foram ainda consultados os relatórios dos exames anatomopatológicos das biópsias realizadas nestes doentes.
Resultados: Todos os indivíduos são leucodérmicos. A média de idades é 65.63±14.42 anos, com 50.0% mulheres e 50.0% homens. 37.5% são fumadores e 75.0% apresentam hábitos alcoólicos. O tempo de seguimento clínico médio é de 2.19±1.67 anos. Clinicamente, observam-se entre três e seis lesões, com dimensões a partir de 2 centímetros. O aspeto verrucoso é mais frequente e a localização preferencial é a gengiva, rebordo alveolar edêntulo e mucosa jugal. Histopatologicamente, observa-se frequentemente hiperqueratose, infiltrado inflamatório liquenóide, hiperplasia e acantose. A presença de displasia epitelial foi registada em 62.5% dos casos e a malignização em 12.5%.
Discussão: Os resultados desta investigação assemelham-se, de um modo geral, aos descritos na literatura. No entanto, a amostra reduzida poderá não ter permitido confirmar a predileção pelo sexo feminino desta entidade patológica. Já o curto período de acompanhamento clínico justificará a menor taxa de transformação maligna registada neste estudo.
Conclusão: Os doentes deverão frequentar consultas de controlo regulares, havendo indicação para a realização de uma biópsia sempre que se verifique uma alteração suspeita das lesões. O médico dentista desempenha um papel fundamental no diagnóstico precoce de cancro oral.
Introduction: Proliferative verrucous leukoplakia (PVL) is a pathological alteration of the oral mucosa with high malignant potential. It is characterized by the presence of multiple white plaques, unassociated with any known etiological factor. The multifocal, proliferative and recurrent nature of these lesions makes their medical or surgical treatment difficult. Objectives: To carry out a descriptive analysis of the demographic, clinical and histological characteristics of a series of eight clinical cases of PVL. Material and Methods: The clinical files of patients diagnosed with PVL followed up at the Department of Surgery and Oral Medicine of the Faculty of Dental Medicine of the University of Lisbon, for the last 10 years, were consulted. The reports of the anatomopathological exams of the biopsies performed in these patients were also consulted. Results: All individuals are leukodermic. The mean age is 65.63±14.42 years, with 50.0% women and 50.0% men. 37.5% are smokers and 75.0% have alcoholic habits. The mean clinical follow-up time is 2.19±1.67 years. Clinically, between three and six lesions are observed, with dimensions starting from 2 centimeters. The verrucous aspect is more frequent and the preferred location is the gingiva, edentulous alveolar ridge and buccal mucosa. Histopathologically, hyperkeratosis, lichenoid inflammatory infiltrate, hyperplasia and acanthosis are frequently observed. The presence of dysplasia was recorded in 62.5% of the cases and malignancy in 12.5% of the cases. Discussion: The results of this investigation are generally similar to those described in the literature. However, the small sample may not have confirmed the predilection of this pathological entity for the female genre. The short clinical follow-up period will justify the lower rate of malignant transformation recorded in this study. Conclusion: Patients should attend regular check-ups, with indication for a biopsy whenever there is a suspicious alteration of the lesions. The dentist plays a key role in the early diagnosis of oral cancer.
Introduction: Proliferative verrucous leukoplakia (PVL) is a pathological alteration of the oral mucosa with high malignant potential. It is characterized by the presence of multiple white plaques, unassociated with any known etiological factor. The multifocal, proliferative and recurrent nature of these lesions makes their medical or surgical treatment difficult. Objectives: To carry out a descriptive analysis of the demographic, clinical and histological characteristics of a series of eight clinical cases of PVL. Material and Methods: The clinical files of patients diagnosed with PVL followed up at the Department of Surgery and Oral Medicine of the Faculty of Dental Medicine of the University of Lisbon, for the last 10 years, were consulted. The reports of the anatomopathological exams of the biopsies performed in these patients were also consulted. Results: All individuals are leukodermic. The mean age is 65.63±14.42 years, with 50.0% women and 50.0% men. 37.5% are smokers and 75.0% have alcoholic habits. The mean clinical follow-up time is 2.19±1.67 years. Clinically, between three and six lesions are observed, with dimensions starting from 2 centimeters. The verrucous aspect is more frequent and the preferred location is the gingiva, edentulous alveolar ridge and buccal mucosa. Histopathologically, hyperkeratosis, lichenoid inflammatory infiltrate, hyperplasia and acanthosis are frequently observed. The presence of dysplasia was recorded in 62.5% of the cases and malignancy in 12.5% of the cases. Discussion: The results of this investigation are generally similar to those described in the literature. However, the small sample may not have confirmed the predilection of this pathological entity for the female genre. The short clinical follow-up period will justify the lower rate of malignant transformation recorded in this study. Conclusion: Patients should attend regular check-ups, with indication for a biopsy whenever there is a suspicious alteration of the lesions. The dentist plays a key role in the early diagnosis of oral cancer.
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