Oral verrucous hyperplasia: histologic classification, prognosis, and clinical implications

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Abstract
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.

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