Verruco-papillary dilemma for the oral diagnostician: A case series of two interesting cases

Abstract

Oral Verrucous Lesions (OVL) comprise of Verrucous Hyperplasia (VH), Verrucous Keratosis, Proliferative Verrucous Leukoplakia (PVL) and Verrucous Carcinoma of Oral Cavity (VC) known as Ackermann’s Tumour. These predominantly emerge as slow proliferating, gray or white, warty, exophytic lesion with micro-nodular surface & commonly seen on the buccal, labial mucosa, gingiva, tongue and palate. These are associated with consumption of tobacco in smoke and smokeless ways and in conjugation with alcohol and viral opportunists have known to be reported. Despite being delineated as benign lesions of minimum aggressive potential, these are difficult to tell apart from each other & long-standing cases have shown transformation into squamous cell carcinoma. This case report, we discuss case scenarios of an 80 year old female and a 42 year old male patient presenting with a diagnostic dilemma of verruco-papillary lesions which was successfully managed by early intervention and surgical intervention and extensive chemo-prevention.