2015 Volume 26 Issue 3 Pages 120-123
Oral leukoplakia is considered to be a whitish patch or plaque that cannot be characterized either clinically or pathologically as any other disease, but various histopathological aspects are seen in the occurrence of oral leukoplakias including different aspects ranging from epithelial hyperplasia to epithelial dysplasia and this is considered to be a precancerous lesion. A general diagnosis including histopathological examinations is considered to be important, because oral leukoplakias should be distinguished from squamous cell carcinoma, which clinically shows a similar appearance to that of oral leukoplakias, and the diagnosis affects the selection of an appropriate therapeutic method. The aim of this study was to evaluate the clinical diagnosis of oral leukoplakias and investigate the rate of concordance between the clinical and histopathological diagnosis, and also to identify appropriate therapeutic methods. The present study included 301 lesions in 236 patients that were clinically diagnosed with oral leukoplakia, and histopathological examinations were performed for 195 of the 228 lesions (82.6%). One hundred and ten patients were male and 85 were female (male : female ratio = 1 : 0.77), with an age range of 27–94 years (mean age, 60.5 years). The most common location of the lesion was the tongue, followed by the gingiva, buccal mucosa, and lip. In addition, the most common clinical type was the white-spotted type, followed by the erythroleukoplakia type, hillock type, and verrucous type. The results of the histopathological examinations showed 187 cases to be oral leukoplakia, while 2 were verrucous carcinoma, 4 were carcinoma in situ, 27 were squamous cell carcinoma, and 8 were oral lichen planus. In the 178 lesions that underwent surgical treatment, 107 lesions were treated by laser using the excision technique, 63 were treated by laser using the vaporization technique, and 8 were treated by surgical excision. The rate of recurrence was 10.3% in cases undergoing laser excision, 38.1% in those undergoing laser vaporization, and 25% in the others. In conclusion, the diagnostic discordance rate in our department was 18%, which was not so low, and it included squamous cell carcinoma in the disconcordant cases, therefore histopathological examinations should be performed to confirm the presence of malignant transformation or the grade of dysplasia. Furthermore, this study suggests that laser therapy for oral leukoplakias is a safe technique compared with other treatment modalities.
