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Oral verrucous hyperplasia (OVH) has long been considered to be a precursor of oral verrucous carcinoma (OVC).1 Evidence for the precursor hypothesis stems from their similar clinicopathological presentations. Both OVH and OVC may present clinically as an exophytic lesion with surface projections (blunt or sharp) imparting a verrucous appearance. Both the lesions are strongly associated with tobacco usage and share similar demographics including a male predominance, affinity to buccal mucosa, and peak prevalence above the 5th decade of life.2 Both OVH and OVC are mostly solitary, but multiple presentations have been reported especially as a part of oral proliferative verrucous leukoplakia. The histopathological similarities of OVH and OVC include a hyperkeratinized surface epithelium with multiple exophytic projections and characteristic keratin pluggings. Both the lesions can also exhibit epithelial dysplasia (ED) and subepithelial inflammatory reaction. Multiple endophytic and exophytic growths are noted in both OVH and OVC.2 Although the above-mentioned clinicopathological similarity strengthens the precursor hypothesis, there are unique histopathological features that distinguish OVH from OVC. These histopathological features can be categorized as major and minor based on the degree of the uniqueness of the feature to a lesion. editorial

Is Oral Verrucous Hyperplasia a Distinct Entity or a Precursor of Oral Verrucous Carcinoma?