OP - ORAL WARTY DYSKERATOMA

A 47-year-old male was referred for evaluation presenting a painless palatal lesion, noticed by his dentist one year ago. Medical history revealed no relevant information. Clinical examination showed a 6 mm shallow depression with small papillary projections on the left side of the hard palate close to palatal gingiva of the second molar. Periapical radiographs showed no alterations on the adjacent bone. The clinical provisional diagnosis was human papillomavirus associated lesion. A conservative surgical procedure removing the entire lesion was performed under local anesthesia and the post-operatory period was uneventful. Five μm hematoxylin and eosin stained histological slides from the surgical specimen showed a stratified squamous epithelium with a central area of hyperkeratosis, acanthosis and dyskeratosis and subjacent connective tissue permeated by a sparse chronic inflammatory infiltrate. The central area of dyskeratosis showed focal areas of intraepithelial cleft and keratin pearl formation, basal cell hyperplasia and nuclear hyperchromatism. Final diagnosis was oral warty dyskeratoma and the patient has been in clinical follow-up for seven months, with no signs of local recurrence. Oral warty dyskeratoma is a rare entity that should be considered on the differential diagnosis of oral papillary lesions.