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Erythroplakia — MFDS Part 1 MCQ

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ModerateOral PathologyErythroplakiaMFDS Part 1

Among the following oral potentially malignant disorders, which is associated with the highest malignant transformation rate?

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Correct answer: AErythroplakia

Erythroplakia has the highest malignant transformation risk among the disorders listed. Comparative meta-analysis has reported a substantially higher pooled rate for erythroplakia than for conventional leukoplakia, oral submucous fibrosis or oral lichen planus; actinic cheilitis also has a lower reported rate. Leukoplakia is more common but is not as high risk overall, although non-homogeneous or dysplastic leukoplakia carries increased risk. Oral lichen planus and oral submucous fibrosis require surveillance but have lower pooled transformation rates. Many erythroplakias demonstrate high-grade dysplasia or are already squamous cell carcinoma when first biopsied. Carcinoma present at the initial biopsy must not be confused with malignant transformation occurring during subsequent follow-up.

Reference: Iocca O, Sollecito TP, Alawi F, et al. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Oral Oncology. 2020;102:104550. https://pubmed.ncbi.nlm.nih.gov/31803979/