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Dental Update 1999. Update On Precancerous Lesions
Dental Update 1999. Update On Precancerous Lesions
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Update on Precancerous
Lesions
GRANT T. MCINTYRE AND RICHARD J. OLIVER
Definitive Diagnosis
The provisional diagnosis (or
diagnoses) will have been reached
following the clinical examination. In
order to determine the definitive
diagnosis, all aetiological factors should
be excluded, and if the lesion persists
the most appropriate special
investigation is incisional or excisional
biopsy. Owing to the polyaetiological
nature of many potentially premalignant
Figure 7. Leukoplakia on the ventral surface of
Figure 6. The appearance of a lichenoid reaction lesions, the histological diagnosis will the tongue. Following excision, histology revealed
to the amalgam restoration in 6|. Histological often be at variance to that determined the presence of an early invasive squamous cell
diagnosis confirmed the clinical diagnosis. clinically. Biopsy is therefore regarded carcinoma.
degrees of dysplasia or those with no lesions exhibiting dysplasia).9 Lesions patients so that precancerous lesions can
dysplasia at all, as a proportion do which exhibit red areas or are be recognized and treated.
progress to malignancy. predominantly red (erythroleukoplakia)
should usually be regarded with the
greatest suspicion and, if possible,
Location of Lesion A CKNOWLEDGEMENTS
erythematous regions should be biopsied.
The exact site of the lesion within the Complete elimination of the lesion should
The authors wish to acknowledge Dr David Felix for
providing the clinical photographs.
mouth should also be considered at the be considered: either by excisional biopsy
outset. Lesions of the tongue and floor of or by laser treatment. Alternatively,
mouth should be regarded with the observation on a regular basis with serial
greatest suspicion as, at these sites biopsy (if required) may be the best R EFERENCES
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Other Investigations
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Other pertinent investigations include aetiology of oral cancer; their synergistic tobacco-related lesions: conclusions of an international
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malignancy (the higher figure quoted for of the oral cavity is mandatory for all Oral Pathol Oral Radiol Endod 1996; 81: 5-14.