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口腔扁平苔藓继发鳞状细胞癌:一例病程长达28年病变的病例报告

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

作者信息

Silveira Wanessa da Silva, Bottezini Ezequiel Gregolin, Linden Maria Salete, Rinaldi Isadora, Paranhos Luiz Renato, de Carli João Paulo, Trentin Micheline, Dos Santos Pâmela Letícia

机构信息

Department of Dentistry, University of Passo Fundo, Passo Fundo, Brazil.

Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2017 Dec;43(Suppl 1):S14-S18. doi: 10.5125/jkaoms.2017.43.S1.S14. Epub 2017 Dec 27.

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.

摘要

扁平苔藓(LP)是一种病因与自身免疫相关的较为常见的黏膜皮肤疾病。鉴于其具有恶变潜能,对LP患者进行正确的诊断、治疗及临床随访十分重要,这样可避免疾病被误诊延误,从而提高治愈几率。本研究旨在描述一例可能源自LP的口腔鳞状细胞癌临床病例。该患者正在接受临床及组织病理学随访。一名64岁的白种男性患者舌部出现增殖性疣状病变,遂前往巴西帕索丰杜大学牙科学院(UPF)寻求治疗。他称该病变自1988年起就已出现,最初被诊断为“口腔扁平苔藓”。体格检查提出了三种诊断假设:斑块状口腔LP、疣状癌和鳞状细胞癌。经切开活检及组织病理学分析,确诊为鳞状细胞癌,可能源自口腔LP。该病例研究表明口腔LP有可能发生恶变,这证明了对口腔LP患者进行定期临床及组织病理学随访以及消除致癌危险因素的合理性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e1f/5770472/486083c50ec9/jkaoms-43-S14-g001.jpg

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