A 65-year-old man with a history of smoking presents with a white patch on the ventral tongue that cannot be scraped off. Biopsy shows epithelial dysplasia with hyperkeratosis. Which type of oral potentially malignant disorder carries the highest risk of malignant transformation?
- A Homogeneous leukoplakia
- B Proliferative verrucous leukoplakia ✓
- C Oral lichen planus
- D Oral submucous fibrosis
Correct answer: B. Proliferative verrucous leukoplakia
Explanation
Proliferative verrucous leukoplakia (PVL) carries the highest malignant transformation rate among oral potentially malignant disorders, with rates reported as high as 70-100% over time. It is characterized by multifocal, recurrent, and progressive lesions that often become verrucous or squamous cell carcinoma. Homogeneous leukoplakia has a lower transformation rate (approximately 5-15%). Oral submucous fibrosis has a transformation rate of approximately 4-8%. Oral lichen planus has a lower malignant potential (approximately 1-3% for erosive forms).
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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