title: Clinical behaviour of malignant transforming oral lichen planus.
abstract: OBJECTIVE
  At present oral lichen planus (OLP) is classified among precancerous conditions but very few data are available in literature regarding prognosis of OLP-related cancers. The aim of this paper is to evaluate clinical long-term behaviour of OLP-related oral squamous cell carcinomas (OSCCs).
  
  
  METHODS
  Clinical history and data from follow-up regarding 21 patients undergoing malignant transformation of OLP have been critically revised.
  
  
  RESULTS
  In a mean time of 2.6 years from diagnosis of OLP, patients developed OSCCs. Histopathologically, two carinomas showed a moderate degree of differentiation, while the others were well differentiated. Six (28.5%) were in situ OSCC, in eight (30%) was found a microinvasive pattern of infiltration, one was a stage II tumour and the remaining (6 cases) were stage I tumours. During follow up, four patients (19%) have developed another OSCC in a mean time of 11 months from the first occurrence. In two men (10% of cases), multiple OSCCs occurred and in five cases (24%) lymph nodal metastases were detected.
  
  
  CONCLUSIONS
  Our study points out an alarming tendency in developing second primary metachronous tumours (33.3%) of the oral cavity and nodal metastases (23.8%), especially if we consider their early stages. Thus we always recommend a strict follow-up of OLP patients with clinical oral and neck examination every 2 months for 6-9 months since OSCC diagnosis is made and, after, three times a year.
authors.affiliation: Department of Oral Medicine and Pathology, University of Naples Federico II, Faculty of Medicine, School of Dentistry, Naples, Italy. mdmig@tin.it
authors.forename: M D
authors.initials: MD
authors.lastname: Mignogna
authors.forename: L
authors.initials: L
authors.lastname: Lo Russo
authors.forename: S
authors.initials: S
authors.lastname: Fedele
authors.forename: E
authors.initials: E
authors.lastname: Ruoppo
authors.forename: L
authors.initials: L
authors.lastname: Califano
authors.forename: L
authors.initials: L
authors.lastname: Lo Muzio
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000503:physiopathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017676:Lichen Planus, Oral / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology* / Q000503:physiopathology; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000473:pathology*; D011446:Prospective Studies; D018570:Risk Assessment; D014062:Tongue Neoplasms / Q000473:pathology / Q000503:physiopathology