Top

Maxillofacial Plastic and Reconstructive Surgery

Published in:

Open Access 01-12-2018 | Case report

Diode laser surgery in the treatment of oral proliferative verrucous leukoplakia associated with HPV-16 infection

Authors: Gian Paolo Bombeccari, Umberto Garagiola, Valentina Candotto, Francesco Pallotti, Francesco Carinci, Aldo Bruno Giannì, Francesco Spadari

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2018

Abstract

Background

Proliferative verrucous leukoplakia (PVL) is an oral potentially malignant disorder, characterized by multifocal expression, progressive clinical evolution, and a high rate of malignant transformation. Evidence-based information regarding optimal PVL management is lacking, due to the paucity of data. The present report describes a case of PVL associated with HPV-16 infection and epithelial dysplasia treated by diode laser surgery, and the outcome of disease clinical remission over a 2-year follow-up period.

Case report

A 61-year-old Caucasian male with oral verrucous hyperkeratosis presented for diagnosis. The lesions were localized on the maxillary gingiva and palatal alveolar ridge. Multiple biopsy specimens have been taken by mapping the keratotic lesion area. Microscopic examination was compatible with a diagnosis of PVL with focal mild dysplasia, localized in the right maxillary gingiva. Polymerase chain reaction (PCR) was done for human papillomavirus (HPV) detection which revealed presence of HPV DNA, and the genotype revealed HPV 16 in the sample. The PVL in the right gingival area was treated on an outpatient basis by excision with a diode laser. This approach resulted in good clinical response and decreased morbidity over a 2-year follow-up period.

Conclusions

This case illustrates the benefit of a conservative approach by diode laser treatment than wide surgical excision for management of the PVL lesions associated with mild dysplasia and HPV-16 infection.

Barnes L, Everson J, Reichart P, Sidransky D (eds) (2005) Pathology and genetics. Head and neck tumours. World Health Organization classification of tumours. IARC Press, Lyon

Borgna SC, Clarke PT, Schache AG, Lowe D et al (2017) Management of proliferative verrucous leukoplakia: justification for a conservative approach. Head Neck 9:1997–2003CrossRef

Hansen LS, Olson JA, Silverman S Jr (1985) Proliferative verrucous leukoplakia: a long-term study of thirty patients. Oral Surg Oral Med Oral Pathol 60:285–298CrossRefPubMed

Abadie WM, Partington EJ, Fowler CB, Schmalbach CE (2015) Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature. Otolaryngol Head Neck Surg 153:504–511CrossRefPubMed

Silverman S Jr, Gorsky M (1997) Proliferative verrucous leukoplakia: a follow-up study of 54 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endodont 84:154–157CrossRef

Gandolfo S, Castellani R, Pentenero M (2009) Proliferative verrucous leukoplakia: a potentially malignant disorder involving periodontal sites. J Periodontol 80:274–281CrossRefPubMed

Klanrit P, Sperandio M, Brown AL, Shirlaw PJ et al (2007) DNA ploidy in proliferative verrucous leukoplakia. Oral Oncol 43:310–316CrossRefPubMed

Ghazali N, Bakri MM, Zain RB (2003) Aggressive, multifocal oral verrucous leukoplakia: proliferative verrucous leukoplakia or not? J Oral Patho l Med 32:383–392CrossRef

Campisi G, Giovannelli L, Ammatuna P et al (2004) Proliferative verrucous vs conventional leukoplakia: no significantly increase risk of HPV infection. Oral Oncol 40:835–840CrossRefPubMed

10.

Palefsky JM, Silverman S Jr, Maha AS et al (1995) Association between proliferative verrucous leukoplakia and infection with human papillomavirus type 16. J Oral Pathol Med 24:193–197CrossRefPubMed

11.

Bagan JV, Jimenez Y, Murillo J et al (2007) Lack of association between proliferative verrucous leukoplakia and human papillomavirus infection. J Oral Maxillofac Surg 65:46–49CrossRefPubMed

12.

Münger K, Howley PM (2002) Human papillomavirus immortalization and transformation functions. Virus Res 89:213–228CrossRefPubMed

13.

Herrero R, Castellsague X, Pawlita M et al (2003) Human papillomavirus and oral cancer: the International Agency for Research on Cancer multicenter study. J Natl Cancer Inst 95:1772–1783CrossRefPubMed

14.

Capella DL, Gonçalves JM, Abrantes AAA, Grando LJ, Daniel FI (2017) Proliferative verrucous leukoplakia: diagnosis, management and current advances. Braz J Otorhinolaryngol 83:585–593CrossRefPubMed

15.

Syrjänen S, Lodi G, von Bültzingslöwen I, Aliko A, Arduino P et al (2011) Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. Oral Dis 17:58–72CrossRefPubMed

16.

Marur S, D'Souza G, Westra WH, Forastiere AA (2010) HPV-associated head and neck cancer: a virus related cancer epidemic. Lancet Oncol 11:781–789CrossRefPubMedPubMedCentral

17.

Pillai MR, Phanidhara A, Kesari AL et al (1999) Cellular manifestations of human papillomavirus infection in the oral mucosa. J Surg Oncol 71:10–15CrossRefPubMed

18.

Proebstle TM, Sandhofer M, Kargl A et al (2002) Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood. Dermatol Surg 28:596–600PubMed

19.

Baeder FM, Santos MT, Pelino JE, Duarte DA, Genovese WJ (2012) High-power diode laser versus electrocautery surgery on human papillomavirus lesion treatment. J Craniofac Surg 23:702–705CrossRefPubMed

20.

Watabe Y, Nomurab T, Ondaa T, Yakushijia T et al (2016) Malignant transformation of oral leukoplakia with a focus on low-grade dysplasia. J Oral and Maxillofac Surg Med Pathol 28:26–29CrossRef

21.

Bagan JV, Jimenez Y, Sanchis JM et al (2003) Proliferative verrucous leukoplakia: high incidence of gingival squamous cell carcinoma. J Oral Pathol Med 32:379–382CrossRefPubMed

22.

Batsakis JG, Suarez P, el-Naggar AK (1999) Proliferative verrucous leukoplakia and its related lesions. Oral Oncol 35:354–359CrossRefPubMed

23.

Salvatori P, Mincione A, Rizzi L, Costantini F, Bianchi A, Grecchi E, Garagiola U, Grecchi F (2017) Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases. Maxillofac Plast Reconstr Surg 39:13. https://doi.org/10.1186/s40902-017-0112-6 CrossRefPubMedPubMedCentral

24.

Garagiola U, Grigolato R, Soldo R, Bacchini M, Bassi G, Roncucci R, De Nardi S (2016) Computer-aided design/computer-aided manufacturing of hydroxyapatite scaffolds for bone reconstruction in jawbone atrophy: a systematic review and case report. Maxillofac Plast Reconstr Surg 38:2. https://doi.org/10.1186/s40902-015-0048-7 CrossRefPubMedPubMedCentral

25.

Spadari F, Garagiola U, Dzsida E, Azzi L, Kálmán FS (2015) Burning oral sensation: when is really BMS? Fogorv Sz 108:137–143PubMed

Title: Diode laser surgery in the treatment of oral proliferative verrucous leukoplakia associated with HPV-16 infection
Authors: Gian Paolo Bombeccari
Umberto Garagiola
Valentina Candotto
Francesco Pallotti
Francesco Carinci
Aldo Bruno Giannì
Francesco Spadari
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2018
Electronic ISSN: 2288-8586
DOI: https://doi.org/10.1186/s40902-018-0156-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Diode laser surgery in the treatment of oral proliferative verrucous leukoplakia associated with HPV-16 infection

Abstract

Background

Case report

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case report

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Effect of the masseter muscle injection of botulinum toxin A on the mandibular bone growth of developmental rats

Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients

Verrucous carcinoma arising from a previous cystic lesion: a case report

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

Treatment of non-odontogenic orofacial pain using botulinum toxin-A: a retrospective case series study

Reconstruction of large oroantral defects using a pedicled buccal fat pad