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AI-Generated response:

Is Leukoplakia considered benign or malignant?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Leukoplakia is considered a potentially malignant disorder, not inherently malignant but with a risk of transformation to malignancy.

  • Leukoplakia presents as mucosal white patches or plaques that cannot be rubbed off and usually exhibits benign hyperkeratosis on biopsy.[1-2]

  • Approximately 7% of leukoplakia lesions undergo malignant transformation into squamous cell carcinoma over time.[2]

  • The risk of malignant transformation is higher in leukoplakias that show epithelial dysplasia on biopsy.[2]

  • Areas of leukoplakia with a corrugated surface or mixed with areas of erythema, especially in patients who use smokeless tobacco, are often found in the lower labial or buccal vestibule and carry a higher risk of transformation.[2]

  • Oral hairy leukoplakia, a variant associated with Epstein-Barr virus infection in immunocompromised individuals, has no malignant potential.[3]

Additional info

Leukoplakia is classified under oral potentially malignant disorders due to its potential to transform into oral squamous cell carcinoma. The transformation rate, although relatively low, necessitates careful monitoring and management of these lesions. Biopsy and histopathological examination are crucial in assessing the dysplastic changes within the leukoplakia lesions, which significantly influence the management strategy and follow-up protocols. The presence of epithelial dysplasia is a critical factor in determining the risk of malignant transformation, guiding the need for possible surgical intervention or more aggressive management approaches. Regular follow-up and re-evaluation are recommended to monitor any changes in the lesion's characteristics, which could indicate progression towards malignancy.

References

Reference 1

1.

Bauman, Julie E. (2024). In Goldman-Cecil Medicine (pp. 1320). DOI: 10.1016/B978-0-323-93038-3.00176-3

The minority of oral squamous cell cancers are preceded by precancerous lesions, termedoral potentially malignant disorders. Acquired potentially malignant disorders, includingleukoplakia(mucosal white patches or plaques that cannot be rubbed off) anderythroplakia(a fiery red patch that cannot be characterized clinically or pathologically as any other diagnosis;Chapter 393), are associated with the consumption of tobacco and alcohol.The presence of loss of heterozygosity within an oral potentially malignant lesion is associated with higher risk of progression to oral cancer within the lesion itself or at another site within the carcinogen-exposed epithelium and is useful for risk stratification.

Reference 2

2.

Jordan, Richard C. (2024). In Goldman-Cecil Medicine (pp. 2620). DOI: 10.1016/B978-0-323-93038-3.00393-2

White plaques are commonly found in the mouth and, like ulcerations, have a wide variety of causes and outcomes (seeTable 393-3). The clinical descriptor termleukoplakiaapplies to a white plaque that does not rub off and whose appearance does not indicate another disease. Leukoplakia can occur in any areaof the mouth and usually exhibits benign hyperkeratosis on biopsy.On long-term follow-up, about 7% of these lesions undergo malignant transformation into squamous cell carcinoma.Leukoplakias that are shown on biopsy to contain epithelial dysplasia have a higher rate of transformation to cancer than those that do not, thereby emphasizing the important role of biopsy for these lesions. Areas of leukoplakia with a corrugated surface or mixed with areas of erythema are often found in the lower labial or buccal vestibule of patients who use smokeless tobacco. Frictional keratoses are often found posterior to the lower molar teeth as irregular white plaques and on the buccal mucosa as white lines adjacent to the dental occlusion. Unlike leukoplakia, these lesions rarely become malignant.

Reference 3

3.

Lalor, Leah (2025). In Nelson Textbook of Pediatrics (pp. 4147). DOI: 10.1016/B978-0-323-88305-4.00705-7

Oral hairy leukoplakia occurs in approximately 25% of patients with AIDS but is rare in the pediatric population. It manifests as corrugated and shaggy white plaques on the lateral margins of the tongue, which cannot be removed by rubbing. The lesions occasionally may spread to the ventral tongue surface, floor of the mouth, tonsillar pillars, and pharynx. The condition is caused by Epstein-Barr virus, which is present in the upper layer of the affected epithelium. The plaques have no malignant potential. The disorder occurs predominantly in HIV-infected patients but may also be found in individuals who are immunosuppressed for other reasons, such as organ transplantation, leukemia, chemotherapy, and long-term use of inhaled steroids. The condition is generally asymptomatic and does not require therapy.

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