ORAL VERRUCOUS HYPERPLASIA OR VERRUCOUS CARCINOMA- A CASE REPORT & DISCUSSION

Abstract

Oral verrucous hyperplasia (OVH) is a premalignant exophytic oral lesion with predominantly verrucous surface and is considered as a forerunner of verrucous carcinoma. Clinically they manifest as a solitary, exophytic, white plaque or pink mass of size more than 1 cm. Verrucous hyperplasia appears in oral mucosa, sinonasal, and laryngeal mucosa. The most common site of oral verrucous hyperplasia lesion in various studies has been observed to be buccal vestibular mucosa, gingiva and alveolar mucosa followed by tongue and floor of the mouth. The hyperplastic epithelium is superficial to the adjacent normal epithelium in verrucous hyperplasia; whereas, in verrucous carcinoma, there is a pushing-border invasion of the hyperplastic epithelium into the underlying connective tissue showing elephant foot shaped reteridges. A novel entity has been proposed called Barnaculate Carcinoma (BC), considered as a intermediate stage between Verrucous Hyperplasia (VH) and Verrucous Carcinoma (VC) and is defined as a bulky, non-invasive epithelial proliferation with characteristic histologic features, including extensive endophytic growth, flat surface, and an intact basement membrane. It resembles VC but lacks the classic invasion or extension beyond the adjacent epithelium. Here we report a case of verrucous hyperplasia showing features of transformation to verrucous carcinoma.