BACKGROUND: Human papillomavirus (HPV) has been causally associated with benign and malignant tumors of the oral mucosa. It is found in the majority of both oral condylomas and oral squamous cell carcinomas. Treatment for these lesions consists of destructive or traditional surgical excision, respectively. OBJECTIVE: Mohs micrographic surgery provides excellent margin control and the highest cure rate for cutaneous malignancies, especially squamous cell carcinoma. Therefore, it represents an excellent alternative for the treatment of HPV-associated malignant and premalignant lesions of the oral mucosa, where the high rate of metastatic potential is compounded by anatomic complexity and the limited amount of normal tissue that may safely be sacrificed with wide excisions. RESULTS: A 38-year-old white man presented with a dysplastic condyloma of the lateral tongue. High-risk HPV-16 deoxyribonucleic acid (DNA) was detected by fluorescent in situ hybridization. Surgical resection of the dysplastic condyloma of the tongue by Mohs micrographic surgery resulted in complete lesion removal, with no evidence of clinical recurrence 8 months after surgery. CONCLUSIONS: Mohs micrographic surgery should be considered as a treatment option for cancerous or precancerous lesions of the oral mucosa, especially when the latter are associated with high-risk HPV.
BACKGROUND:Human papillomavirus (HPV) has been causally associated with benign and malignant tumors of the oral mucosa. It is found in the majority of both oral condylomas and oral squamous cell carcinomas. Treatment for these lesions consists of destructive or traditional surgical excision, respectively. OBJECTIVE: Mohs micrographic surgery provides excellent margin control and the highest cure rate for cutaneous malignancies, especially squamous cell carcinoma. Therefore, it represents an excellent alternative for the treatment of HPV-associated malignant and premalignant lesions of the oral mucosa, where the high rate of metastatic potential is compounded by anatomic complexity and the limited amount of normal tissue that may safely be sacrificed with wide excisions. RESULTS: A 38-year-old white man presented with a dysplastic condyloma of the lateral tongue. High-risk HPV-16 deoxyribonucleic acid (DNA) was detected by fluorescent in situ hybridization. Surgical resection of the dysplastic condyloma of the tongue by Mohs micrographic surgery resulted in complete lesion removal, with no evidence of clinical recurrence 8 months after surgery. CONCLUSIONS: Mohs micrographic surgery should be considered as a treatment option for cancerous or precancerous lesions of the oral mucosa, especially when the latter are associated with high-risk HPV.