Verrucous hyperplasia (VH) is an uncommon oral potentially malignant disorder characterized by a verrucous or papillary exophytic proliferation of the oral epithelium without invasion into the underlying connective tissue. It is considered a precursor lesion to verrucous carcinoma and conventional oral squamous cell carcinoma, and therefore requires early recognition and appropriate management. VH is often associated with chronic local irritants such as poor oral hygiene, tobacco use, mechanical irritation, and persistent inflammatory stimuli. This case report describes a 41-year-old female who presented with a painless gingival growth in the mandibular anterior region that had been present for one month. The patient also reported a sensation of heaviness in the left maxillary posterior region. Clinical examination revealed a well-defined exophytic growth on the gingiva in relation to the mandibular anterior teeth, with a verrucous surface texture. The lesion was firm in consistency and non-tender on palpation. Considering the clinical features, differential diagnoses included verrucous hyperplasia, verrucous carcinoma, and other reactive gingival lesions. An excisional biopsy was performed under local anaesthesia, and the specimen was submitted for histopathological evaluation. Microscopic examination demonstrated hyperplastic stratified squamous epithelium with elongated rete ridges and surface keratinization, along with epithelial dysplastic changes confined predominantly to the superficial epithelial layers. Importantly, there was no evidence of epithelial invasion into the underlying connective tissue, confirming the diagnosis of verrucous hyperplasia. The lesion was managed through complete surgical excision along with elimination of local etiological factors and improvement of oral hygiene measures. The patient was placed on periodic follow-up to monitor for recurrence or malignant transformation. Early diagnosis, histopathological confirmation, and prompt surgical management are critical in preventing the progression of verrucous hyperplasia to invasive carcinoma.
Godvine, Laxmi Shravya, Sarah Fatima, Israa Mohammed Younus*, Choppari Sai Varsha, Chintala Shruthi, Enugala Anvitha, Chunduri Sri Vaishnavi, E Krishna Priya, CH. Soniya, Lasya Snkp Duggirala (Sat,) studied this question.