Evaluation of Epithelial Dysplasia and Invasion through the Basement Membrane in Oral Verrucous Carcinoma: A study on 45 cases

Background: Oral Verrucous carcinoma (OVC) is a rare variant of well differentiated squamous cell carcinoma (SCC). Epithelial dysplasia and/or foci of invasion in OVC are indicators of worse prognosis. The aim of this study was to evaluate the epithelial dysplasia and invasion through the basement membrane in OVC. Method: This was a cross-sectional observational study conducted at the Department of Pathology, BSMMU during 2021-2023 that included 45 cases of histologically diagnosed OVC. Demographic variables, presence or absence of epithelial dysplasia in routine H&E stain and presence or absence of invasion through the basement membrane by PAS stain were assessed. Thirty three cases were followed up and reports of the subsequent biopsies were collected. Research data were placed in a data sheet. Results of all cases were tabulated. Statistical analysis was performed on the tabulated data by Fisher’s Exact Test. Result: In this study, 33.3% cases revealed epithelial dysplasia in OVC and 11.5% cases showed invasive foci through the BM. We followed up the study cases and 15.6% cases were diagnosed as invasive SCC in subsequent biopsy. Statistical analysis revealed presence of invasion through the BM significantly higher in OVC cases having epithelial dysplasia. Similarly, in subsequent biopsy ISCC was found significantly higher in previously diagnosed cases of OVC having features of epithelial dysplasia. Conclusion: Epithelial dysplasia in OVC signifies the increased possibility of its progression to conventional invasive SCC and is an important prognostic factor. So, earlier detection of epithelial dysplasia and/or foci of invasion in OVC will help the clinician in properly managing the patient.