Concurrent verrucous carcinomas of the lip and buccal mucosa

Florid oral papillomatosis presents a picture of multiple squamous papillary lesions found in the oral pharynx. Multiple risk factors associated with the development of these lesions include possible association with papilloma virus, the use of tobacco products, and chronic inflammation or irritation such as that caused by poorly fitted dentures. The major risk factor of these benign squamous lesions is the dedifferentiation into a well-differentiated verrucous carcinoma. However, treatment in the early stage of the disease is usually successful. Surgical excision has been favored as the initial approach. The use of radiotherapy for verrucous carcinoma is controversial. In numerous reported cases dedifferentiation of the tumor has produced an anaplastic squamous cell carcinoma. More recent articles, however, indicate that the risk for dedifferentiation of verrucous carcinoma due to radiotherapy may be overstated.