Oral surgery, oral medicine, oral pathology and oral radiology · 2026
Proliferative verrucous leukoplakia: a Brazilian multicenter study of 40 cases with exploratory assessment of contemporary diagnostic criteria.
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de Sousa Rafael Aguiar, de Arruda José Alcides Almeida, Souto Giovanna Ribeiro, Tarquinio Sandra Beatriz Chaves, Mesquita Ricardo Alves, Drumond Victor Zanetti, Pereira Beatriz Lages Diniz, Barbosa Mathias Ponche, de Andrade Bruno Augusto Benevenuto, Tenório Jefferson R, Ribeiro Marcela Ferreira Abrahão, de Souza Paulo Eduardo Alencar, Horta Martinho Campolina Rebello, de Aguiar Maria Cássia Ferreira
Аннотация
OBJECTIVE: To describe the clinicodemographic and histopathological features of proliferative verrucous leukoplakia (PVL) in a multicenter cohort and assess the availability of variables required for retrospective application of contemporary diagnostic criteria.
STUDY DESIGN: This retrospective multicenter study included 40 patients with PVL from four Brazilian referral centers. All cases met a clinicopathological case definition based on the World Health Organization description of PVL. Clinicodemographic, histopathological, and follow-up data were analyzed descriptively. Medical records were reviewed for documentation of variables required by diagnostic criteria.
RESULTS: Most patients were female (85%); median age was 70 years. The gingiva/alveolar mucosa/retromolar area and buccal mucosa were the most frequent sites (55% each). At least two lesions were documented in 90% of patients, including three or more lesions in 72.5%. Nonhomogeneous morphology was documented in 47.5%. During a median follow-up of 3.8 years, recurrence occurred in 75% and malignant transformation in 22.5%. Patients underwent a median of two biopsies, showing findings ranging from hyperkeratosis to invasive squamous cell carcinoma. All variables required for retrospective application were documented in 24 cases (60%); at least one required variable was undocumented in 16 (40%).
CONCLUSION: PVL exhibits marked clinicopathological heterogeneity and substantial malignant potential. Prospective documentation is essential for applying diagnostic criteria, improving comparability across studies, and guiding surveillance.
STUDY DESIGN: This retrospective multicenter study included 40 patients with PVL from four Brazilian referral centers. All cases met a clinicopathological case definition based on the World Health Organization description of PVL. Clinicodemographic, histopathological, and follow-up data were analyzed descriptively. Medical records were reviewed for documentation of variables required by diagnostic criteria.
RESULTS: Most patients were female (85%); median age was 70 years. The gingiva/alveolar mucosa/retromolar area and buccal mucosa were the most frequent sites (55% each). At least two lesions were documented in 90% of patients, including three or more lesions in 72.5%. Nonhomogeneous morphology was documented in 47.5%. During a median follow-up of 3.8 years, recurrence occurred in 75% and malignant transformation in 22.5%. Patients underwent a median of two biopsies, showing findings ranging from hyperkeratosis to invasive squamous cell carcinoma. All variables required for retrospective application were documented in 24 cases (60%); at least one required variable was undocumented in 16 (40%).
CONCLUSION: PVL exhibits marked clinicopathological heterogeneity and substantial malignant potential. Prospective documentation is essential for applying diagnostic criteria, improving comparability across studies, and guiding surveillance.