Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Case Report of Squamous Cell Carcinoma arising in an Oral Lichen Planus and Literature Investigation

구강편평태선 환자에서 발생한 암종의 증례보고 및 문헌 고찰

  • Lim, Hyun-Dae (Department of Oral medicine, School of Dentistry, Wonkwang University) ;
  • Lee, You-Mee (Department of Oral medicine, School of Dentistry, Wonkwang University)
  • 임현대 (원광대학교 치과대학 구강내과학 교실) ;
  • 이유미 (원광대학교 치과대학 구강내과학 교실)
  • Published : 2009.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Lichen planus is a relatively common chronic inflammatory disease involving the skin and mucous membranes showing small flat polygonal papules. The accurate etiology is unknown but it's suggested that cell-mediated immune response to an induced antigenic changes in skin or mucosa. Oral lichen planus was regarded as an benign lesion but oral lichen planus was classified as premalignant lesion by WHO criteria. It was not known that progress of malignat transmmission in the the patient with oral lichen planus, and chronic inflammatory disease including oral lichen planus showed malignacy in oral cancer unrelated common risk factors(Ex: tabacco, alcohol). Although malignant development in the patient with oral liche planus was various greatly in the literature, from 0.5% upward to 5%. It has been reported that a specific clinical type of oral lichen planus, hyperkeratotic or erosive had a higher chance of transformation into an squamous carcinoma. Clinician has to follow-up check of at least one or two visit per year to detect of malignancy of oral lichen planus and improved prognosis with squamous cell carcinoma. At this case with the middle aged women with squamous cell carcinoma developed from oral lichen planus of more than a decade of persisting, we try to discuss the malignacy of oral lichen planus and cosideration with follow-up.

편평태선은 작고 편평한 다각형의 구진을 피부나 점막에 보이는 만성 염증성 질환으로 편평태선을 유발하는 원인은 명확하지는 않으나, 피부나 점막에서의 항원변화가 세포매개성 면역반응을 유도하여 발생하는 것으로 생각되어진다. 구강편평태선은 초기에는 양성 병소로 생각되었으나 세계보건기구에 의해 전암 병소로 분류되었다. 구강편평태선이 악성화되는 단계는 명확하게 밝혀지지 않았으며, 편평태선등의 만성 염증성 질환은 구강암 발생에 있어 일반적인 위험 요인(예: 흡연, 음주)과 관계없이 악성 발현을 보인다. 구강편평태선의 악성전이는 여러 문헌에서 논란을 보이나, 0.5%에서 5%까지 보고되었다. 구강편평태선의 악성 전이는 특정 임상적 양상, 과각화나 미란성에서 더 높은 비율로 발생한다. 구강편평태선의 악성 전이는 예후가 불량하므로 예후의 개선과 조기 진단을 위하여 임상가는 일년에 최소 일회에서 2회까지 추적 조사를 해야 한다. 본 증례 보고에서는 중년의 여성에게서 십수년간 지속된 구강편평태선에서 발생한 편평상피암종을 살펴봄으로써, 임상가가 유념해야 할 구강편평태선의 악성 변이에 대한 고찰 및 진단시와 추적 조사시에 고려사항을 고찰하자고 한다.

Keywords

References

  1. Ditrichova D, Kapralova S, Tichy M et al. Oral lichenoid lesions and allergy to dental materials. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007;151(2):333-339 https://doi.org/10.5507/bp.2007.057
  2. Laskaris G. Color atlas of oral disease. Athens, 1986, Litsas medical Pub., pp. 184-187
  3. Lo Muzio L, Mignogna MD, Favia G et al. The possible association between oral lichen planus and oral squamous cell carcinoma : a clinical evaluation on 14 cases and a review of literature. Oral Oncology 1998;34:239-246 https://doi.org/10.1016/S1368-8375(98)80001-8
  4. Mignogna MD, Lo Muzio L, Russo L et al. Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus : a 5-year experience. Oral Oncology 2001;37:262-267 https://doi.org/10.1016/S1368-8375(00)00096-8
  5. Barnard NA, Scully C, Eveson JW, Cunninham S et al. Oral cancer development in patient with oral lichen planus. J Oral Pathol Med 1993;22:421-424 https://doi.org/10.1111/j.1600-0714.1993.tb00134.x
  6. Munoz AA, Haddad RI, Woo SB, et al. Behavior of oral squamous cell carcinoma in subjects with prior lichen planus. Otolaryngology-Head and Neck Surgery 2007;136:401-404 https://doi.org/10.1016/j.otohns.2006.09.023
  7. Holmstrup P. The controversy of a premalignant potential of oral lichen planus is over. Oral Surg Oral Med Oral Pathol June 1992;704-706
  8. Braakuis BJ, Tabor MP, Kummer JA et al. A genetic expanation explanation of Slaughter's concept of field cancerization:evidence and clinical implication. Cancer Res 2003;63:1727-1730
  9. HA PK, Califano JA. The molecular biology of mucosal field cancerization of the head and neck. Crit Rev Oral Biol Med 2003;14:363-369 https://doi.org/10.1177/154411130301400506
  10. M.D. Mignogna, S. Fedele, L. Lo Russo et al. Field cancerization in oral lichen planus. EJSO 2007;33:383-389 https://doi.org/10.1016/j.ejso.2006.09.028
  11. Krutchkoff DJ, Cutler L, Laskowski S. Oral lichen planus: the evidence regarding potential malignant transformation. J Oral Pathol 1978;7:1-7 https://doi.org/10.1111/j.1600-0714.1978.tb01879.x
  12. Eisenberg E, Krutchkoff DJ. Lichenoid lesions of oral mucosa. Diagnostic criteria and their importance in the alleged relationship to oral cancer. Oral Surg Oral Med Oral Pathol 1992;73:699-704 https://doi.org/10.1016/0030-4220(92)90013-G
  13. Van der Meij EH, Schepman KP, Smeele LE et al. A review of the recent literature regarding malignant transformation of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:307-10 https://doi.org/10.1016/S1079-2104(99)70033-8
  14. WHO Collaborating Centre for Oral Precancerous Lesions. Definition of leukoplakia and related lesions:an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol 1978;46:518-39 https://doi.org/10.1016/0030-4220(78)90383-3
  15. Mignogna MD, Lo Russo L, Fedele S et al. Clinical behaviour of malignant transforming oral lichen planus. Eur J Surg Oncol 2002;28:838–843 https://doi.org/10.1053/ejso.2002.1302
  16. Epstein JB, Wan LS, Gorsky M et al. Oral lichen planus: Progress in understanding its malignant potential and the implications for clinical management. Oral Surg Oral Med Oral Pathol 2003;96(1):32–37 https://doi.org/10.1016/S1079-2104(03)00161-6
  17. Gandolfo S, Richiardi L, Carrozzo M et al. Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population. Oral Oncol 2004;40:77–83 https://doi.org/10.1016/S1368-8375(03)00139-8
  18. Ogmundsdottir HM, Hilmarsdottir H, Astvaldsdottir A et al. Oral lichen planus has a high rate of TP53 mutations. A study of oral mucosa in Iceland. Oral Surg Oral Med Oral Pathol 2002;93(5):586–592 https://doi.org/10.1067/moe.2002.124462
  19. Majid Ebrahimi, Linda Boldrup, Philip J. Coates et al. Expression of novel p53 isoforms in oral lichen planus. Oral Oncology 2008;44:156-161 https://doi.org/10.1016/j.oraloncology.2007.01.014
  20. Amanda A. Munoz, MD. Rovert I et al. Behavior of oral squamous cell carcinoma in subjects with prior lichen planus. Otolaryngology-Head and neck surgery 2007;136:401-404 https://doi.org/10.1016/j.otohns.2006.09.023
  21. Krogh P, Hald B, Holmstrup P. Possible mycological etiology of oral mucosal cancer: catalytic potential of infecting Candida albicans and other yeasts in production of N-nitrosobenzylmethylamine. Carcinogenesis 1987;8:1543-8 https://doi.org/10.1093/carcin/8.10.1543
  22. Laeijendecker R, Van Joost T, Kuizinga MC et al. Premalignant nature of oral lichen planus. Acta Derm Venereol 2005;85:516-520
  23. Rajentheran R, McLean NR, Kelly CG et al. Malignant transformation of oral lichen planus. European Jounal of Surgical Oncology 1999;25:520-523 https://doi.org/10.1053/ejso.1999.0689