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O Liquen Plano Oral (LPO) e uma doenca cronica imunologicamente mediada com potencial de malignizacao incerto. O objetivo desse artigo e relatar um caso de Carcinoma de Celulas Escamosas (CCE) diagnosticado em paciente com diagnostico previo de LPO. Paciente do sexo feminino, 69 anos, foi atendida durante uma campanha de diagnostico precoce de câncer de boca realizada na cidade de Londrina/PR, sendo detectada uma lesao eritroplasica em lingua e encaminhada para uma melhor avaliacao. Na anamnese a paciente relatou que ha 2 anos atras foi diagnosticada com LPO atraves de biopsia em lingua, nao sendo proposto nenhum tratamento. Ao exame fisico, observamos uma mancha eritematosa em borda lateral de lingua do lado esquerdo, nao apresentando nenhuma outra lesao na cavidade oral. Com a hipotese diagnostica de eritroplasia, foi requisitada a lâmina da biopsia anterior para analise, que revelou caracteristicas microscopicas incompativeis com o diagnostico de LPO. Optamos entao por realizar uma nova biopsia e a analise histopatologica revelou ilhas de celulas epiteliais malignas invadindo o tecido conjuntivo, estabelecendo o diagnostico de CCE. A paciente foi encaminhada para tratamento, sendo realizada glossectomia parcial. Em acompanhamento de 6 meses a paciente encontra-se bem e sem sinais de recidiva. A transformacao maligna do LPO ainda e discutida na literatura e muitos casos relatados podem se tratar de erro no diagnostico inicial, como no caso apresentado. O erro de diagnostico pode levar a morbidades importantes e comprometer o prognostico do caso.Descritores: Diagnostico; Liquen Plano; Carcinoma de Celulas Escamosas.ReferenciasGiuliani M, Troiano G, Cordaro M, Corsalini M, Gioco G, Lo Muzio L et al. Rate of malignant transformation of Oral Lichen Planus: a systematic review. Oral Dis. 2019; 25(3):693-709.Bardellini E, Amadori F, Flocchini P, Bonadeo S, Majorana A. Clinicopathological features and malignant transformation of oral lichen planus: a 12-years retrospective study. Acta Odontologica Scandinavica 2013;71(3/4):834-40.Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol. 2002;46(2):207-14.Farhi D, Dupin N. Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies. Clin Dermatol. 2010;28(1):100-8.Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus – a review. J Oral Pathol Med. 2010;39(10):729-34.van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32(9):507-12.Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol. 1978;46(4):518-39.Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS et al. Malignant transformation of oral lichen planus and oral lichenoid lesions: a meta-analysis of 20095 patient data. Oral Oncology. 2017;68:92-102.Eisenberg E. Oral lichen planus:a benign lesion. J Oral Maxillofac Surg. 2000;58(11):1278-85. Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539-51.Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):164-78.Sousa FACG, Paradella TC, Brandao AAH, Rosa LEB. Liquen plano bucal versus displasia epitelial: dificuldades diagnosticas. Braz J Otorhinolaryngol. 2009;75(5):716-20.Rode M, Kogoj-Rode M. Malignant potential of the reticular form of oral lichen planus over a 25-year observation period in 55 patients from Slovenia. J Oral Sci. 2002;44(2):109-11.Van der Meij EH, Mast H, Van der Waal I. The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective five-year followup study of 192 patients. Oral Oncol. 2007;43(8):742-48.Oliveira Alves MG, Almeida JD, Balducci I, Guimaraes Cabral LA. Oral lichen planus: a retrospective study of 110 Brazilian patients. BMC Res Notes. 2010;3:157.Radochova V, Drˇizhal I, Slezak R. A retrospective study of 171 patients with oral lichen planus in the East Bohemia-Czech Republic–single center experience. J Clin Exp Dent. 2014;6(5):e556-61.Fitzpatrick S, Hirsch S, Gordon S. The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. J Am Dent Assoc. 2014;145(1):45-56.Bermejo-Fenoll A, Sanchez-Siles M, Lopez-Jornet P, Camacho-Alonso F,  Salazar-Sanchez N. A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain. J Oral Pathol Med. 2010;39(6):491-96.Chaiyarit P, Ma N, Hiraku Y, Pinlaor S, Yongvanit P, Jintakanon D et al. Nitrative and oxidative DNA damage in oral lichen planus in relation to human oral carcinogenesis. Cancer Sci. 2005;96:553-59.Georgakopoulou EA, Achtari MD, Achtaris M, Foukas PG, Kotsinas A. Oral lichen planus as a preneoplastic inflammatory model. J Biomed Biotechnol. 2012;2012:759626.Accurso BT, Warner BM, Knobloch TJ, Weghorst CM, Shumway BS, Allen CM et al. Allelic imbalance in oral lichen planus and assessment of its classification as a premalignant condition. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):359-66.

Descoberta de carcinoma de células escamosas em lesão previamente diagnosticada como líquen plano oral: malignização ou erro de diagnóstico inicial?