Clinicopathological Discordance of Biopsy Findings in Proliferative Verrucous Leukoplakia: Series of 5 Cases

Background

Proliferative verrucous leukoplakia (PVL) is a rare but aggressive variant of oral leukoplakia. Lesions within the spectrum of PVL are characterised by high recurrence rates and high risk of malignant progression. Their multifocal and metachronous occurrence in patients necessitates close follow-up with combined clinical and histopathological examination by sampling biopsies. However, their clinical reliability is limited due to the elusive clinical presentation of PVL, as histological features can differ within a single lesion. To date, there are no studies that have investigated the diagnostic accuracy of biopsies of PVL-associated lesions. Case Presentation: Out of a total of 33 reviewed patients from retrieved records, five cases with discordant biopsies were identified and were analysed in more detail based on available photographic documentation and histopathological findings. The presentation seeks to illustrate the resulting diagnostic and therapeutic challenges of inconclusive biopsies in PVL.