Oral leukoplakia in chronic graft versus host disease
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Tipo de produção
conferenceObject
Data de publicação
2012
Título da Revista
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Título do Volume
Editora
WILEY-BLACKWELL
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Citação
ORAL DISEASES, v.18, suppl.1, Special Issue, p.40-40, 2012
Resumo
Introduction: Late complications of allogeneic hematopoietic stem cell transplantation (HSCT) include a risk of secondary malignancies and early diagnosis of oral premalignant or malignant lesions requires an assessment of potential predisposing risk factors. Patients with oral epithelial dysplasia after allogeneic HSCT include oral cGVHD as a potential risk factor for oral cancer. A better understanding of the clinical features and potential factors associated with secondary oral cancer, may be benefit predicting and identifying this late complication of allogeneic HSCT. Case details: A 37 years old male who had received an allogeneic hematopoietic stem cell transplantation in October/2002 was referred to a Oral Medicine Outpatient in August 2011 with a white-plaque lesion of the oral mucosa the conditioning regimen to HSCT comprised busulfan-melphalan and graft-versus-host disease prophylaxis was cyclosporine-methotrexate. The patient developed lichenoid-oral cGVHD around day 60 and treatment comprised corticosteroid-cyclosporine. Clinical examination revealeda non-symptomatic 2 cm white-plaque of the hard palate. Exfoliative cytology was performed and no atypical cells were seen. The lesion increased in size to 4 cm long during the next 10-days. An incisional biopsy was undertaken and histopathological analysis revealed an epithelial tissue with acanthosis, hypergranulosis, hyperkeratosis, papilomatosis and apoptosis plus lymphocyte exocitosis. No atypical, cell dysplasia or koylocites were present. Mild to moderate cGVHD activity was seen. In this case, the patient was monitored in our outpatient program and no changes were noted in the lesion. Conclusion: The associationbetweenchronic graftversus host disease andoralsquamous cell carcinoma suggests a close monitoring of patients for early diagnosis of possible secondaryneoplasmsanddemonstratestheaggressivebehaviourofthislatecomplication. Relevance: Due to this aggressive behaviour and the increase number of HSCT worldwide, careful long-term follow-up by a cancer team, including oral medicine expertise, is recommended, and patients should be aware of cancer risk.