Precancerous lesions of oral mucosa

Abstract

Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used.

Keywords: Oral premalignant lesions, Leukoplakia, Erythroplakia, Submucous fibrosis, Lichen planus, Malignant transformation

Core tip: Precancerous lesions of oral mucosa are the diseases that have malignant transformation risk at different ratios. Clinically, these diseases may sometimes resemble each other. Thus, the diagnosis should be confirmed by biopsy. In early stages, histopathological findings are distinctive, but if malignant transformation occurs, identical histological features with oral carcinoma are seen. If these diseases left untreated, they can cause many problems, which may affect a patient’s social and daily life.