Laser surgical management of proliferative verrucous leukoplakia: a case report.
Thaís Savier Pereira Silva, João Pedro Denardi Monteiro, Norberto Nobuo Sugaya et al.
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Case in brief
A 54-year-old male smoker presented with asymptomatic oral white plaques that had persisted for approximately 5 years. Examination showed irregular, variably thick and nonhomogeneous lesions across multiple oral sites, including both buccal mucosae and the oropharynx. Biopsies showed hyperkeratosis with mild epithelial dysplasia; the clinical and histopathologic findings supported a diagnosis of proliferative verrucous leukoplakia (PVL). Because of the lesions’ extent and appearance, he underwent 9 high-power 980-nm diode-laser procedures at 45- to 60-day intervals. At 18 months after the first treatment, he remained satisfied, with no significant recurrence, and continued regular monitoring.
What made this case unusual
PVL, which mainly affects middle-aged and older women, occurred in a male smoker; the lesions were extensive and involved multiple oral sites.
Diagnostic / clinical pearl
PVL diagnosis depends on integrating clinical features with histopathology; biopsies and ongoing surveillance may be needed as lesions persist or evolve.
Why it matters
This case describes high-power diode-laser surgery as an option for controlling extensive PVL lesions, with no significant recurrence reported at 18 months.