J Korean Assoc Oral Maxillofac Surg.  2017 Dec;43(Suppl 1):S14-S18. 10.5125/jkaoms.2017.43.S1.S14.

Squamous cell carcinoma from oral lichen planus: a case report of a lesion with 28 years of evolution

• Silveira W
• Bottezini
• Linden MS
• Rinaldi I
• Paranhos L
• Carli JP
• Trentin M
• Santos PL

• KMID: 2399920
• DOI: http://doi.org/10.5125/jkaoms.2017.43.S1.S14

Abstract

Lichen planus (LP) is a relatively common mucocutaneous disease with autoimmune etiology. Considering its malignancy potential, it is important to define the correct diagnosis, treatment, and clinical follow-up for patients with LP so that the disease is not diagnosed late, thus hindering the chances of curing the disease. This study aims to describe a clinical case of oral squamous cell carcinoma, potentially originated from LP. The patient is undergoing clinical and histopathological follow-up. A 64-year-old Caucasian male patient presented with a proliferative verrucous lesion on the tongue and sought treatment at the School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Brazil. He claimed the lesion had been present since 1988, and had been initially diagnoses as "oral lichen planus." The physical exam presented three diagnostic hypotheses: plaque-like oral LP, verrucous carcinoma, and squamous cell carcinoma. After incisional biopsy and histopathological analysis, squamous cell carcinoma was diagnosed, probably originating from oral LP. The case study shows that malignancy from oral LP is possible, which justifies periodic clinical and histopathological follow-up, as well as the elimination of risk factors for carcinoma in patients with oral LP.

Keyword

Squamous cell carcinoma; Oral lichen planus; Oral cancer; Mouth neoplasms

MeSH Terms

Biopsy
Brazil
Carcinoma, Squamous Cell*
Carcinoma, Verrucous
Dentistry
Diagnosis
Epithelial Cells*
Follow-Up Studies
Humans
Lichen Planus
Lichen Planus, Oral*
Lichens
Male
Middle Aged
Mouth Neoplasms
Risk Factors
Tongue

Figure

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  Fig. 1 Initial clinical aspect of the vegetating lesion in the dorsum of the tongue.

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  Fig. 2 Initial clinical aspect of the vegetating lesion in the belly of the tongue.

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  Fig. 3 Anesthetic infiltration before incisional biopsy.

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  Fig. 4 Collection of a lesion sample with needle and suture thread.

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  Fig. 5 Lesion with suture thread.

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  Fig. 6 Scaphoid-shaped surgical site immediately after biopsy.

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  Fig. 7 Suture performed in the incisional biopsy area.

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  Fig. 8 Aspect of the lesion after incisional biopsy.

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  Fig. 9 Aspect of the lesion 2 years after incisional biopsy, 6 chemotherapy sessions, and 35 radiotherapy sessions.

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  Fig. 10 Grade I squamous cell carcinoma composed of numerous atypical pleomorphic cells and keratin pearls (H&E staining, ×100).

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