Pentingnya Mendeteksi Oral Leukoplakia Sebagai Oral Potentially Malignant Disorders (Laporan Kasus)

Abstract

Oral Leukoplakia (OL) is white plaque lesion in oral mucosa thatcannot be scraped and one of Oral Potentially Malignant Disorder(OPMD) with incidence about 2.5% of all populations in the world.The most case of oral squamous cell carcinoma are preceded byOPMD. The aim of this case report is to understand the importance ofdetection oral lesion that could potentially become malignancy. A 28-year-old male patient complained of sores on his tongue that had nothealed for 2 months. Intraoral examination obtained red and whitelesion on the left lateral tongue: shallow reddish ulcer with irregularborder in region 35-36, followed by unscrapable white plaque lesionwith slight induration in region 37-38. Hematological examinationshowed normal range. According anamnesis and clinical examination,diagnosis of traumatic ulcer and OL were made. Patients were treatedwith multivitamins and antiseptic mouthwash. Histopathologicalexamination results from lesion biopsies show a hyperplastic mass,parakeratosis and a tissue with polymorphic form, a hyperchromaticnucleus of cells associated with histopathologic criteria of squamouscell carcinomas with well differentiation. The patient was referred tothe Hemato-oncology Department for chemotherapy. There are twoimportant parameters should be considered when evaluating thepotential for malignant change of OL that is when finding white lesionswith or without red lesions should always be suspected as OPMD andalways confirm it by histopathological examination as early aspossible. Accurate examination and histopathologic examination isessential to obtain a good prognosis in OPMD.

Oral Leukoplakia, the First Clinical Finding of Oral Squamous Cell Carcinoma (Oscc): A Case Report

“…Clinically the diagnosis is made based on visual examination such as leukoplakia (white patches in the mouth), erythroplakia (red patches) and oral submucosal fibrosis (irreversible fibrosis of the submucosal tissue), and the presence of dysplasia histopathologically. 8,9,10,11 The term "Potentially Malignant Disorders" was first introduced in 2005 at a workshop held by WHO in London. This meeting replaced the terms such as precancer and pre-malignant to "Potentially Malignant Disorders" (OPMD) which are grouped into two, namely precancerous lesions and precancerous conditions.…”

“…5,6,7 OSCC is preceded by precancerous lesions that are clinically established based on visual examination such as leukoplakia (white patches in the mouth), erythroplakia (red patches) and oral submucosal fibrosis (irreversible fibrosis of the submucosal tissue) and histopathologically there is dysplasia. 8,9,10,11 Leukoplakia derived from Greek Language; Leucos means white and placos means plaque, therefore leukoplakia is often referred to as white plaque. Since several decades ago, the term oral leukoplakia (OL) was used to describe white plaque in the oral cavity that cannot be removed, with an incidence of about 0.4-2.6% of the world's population.…”

“…Since several decades ago, the term oral leukoplakia (OL) was used to describe white plaque in the oral cavity that cannot be removed, with an incidence of about 0.4-2.6% of the world's population. 8 The etiology of leukoplakia is not known for sure, but it can be triggered by many factors such as smoking, fungal, viral, and bacterial infections. 8,9,10,12,13 OL is classified as Oral Potentially Malignant Disorder (OPMD), along with various oral lesions and conditions such as oral lichen planus, and erythroplakia, which initiated by the occurrence of epithelial dysplasia as a change towards malignancy to oral squamous cell carcinoma (OSCC).…”

“…8 The etiology of leukoplakia is not known for sure, but it can be triggered by many factors such as smoking, fungal, viral, and bacterial infections. 8,9,10,12,13 OL is classified as Oral Potentially Malignant Disorder (OPMD), along with various oral lesions and conditions such as oral lichen planus, and erythroplakia, which initiated by the occurrence of epithelial dysplasia as a change towards malignancy to oral squamous cell carcinoma (OSCC). The rate of dysplastic change or malignancy in OL varied between 15.6% -39.2%.…”

“…Clinically, OL with red lesions, although rare, has also been shown to have a higher risk of malignancy. 7,8,9,10 The use of histopathological criteria to assess the degree of oral epithelial dysplasia through biopsy is a useful main indicator to determine the risk of malignancy change, although not all epithelial dysplasia of the oral mucosa develops into OSCC. 14 Oral leukoplakia can turn into OSCC, with a survival rate of about 80% in stages I and II, and 20% stages III and IV.…”