Direct fluorescence visualization of clinically occult high‐risk oral premalignant disease using a simple hand‐held device

TLDR

Many oral cancers and precancers are clinically occult, contributing to late diagnosis and high mortality. The study aims to develop a simple method to detect such occult oral lesions. A hand‑held autofluorescence device was used to visualize loss of fluorescence in the oral cavity, and lesions showing loss were biopsied. In three longitudinal cases, the device detected occult lesions that were confirmed as dysplasia, a second primary cancer, and recurrence, demonstrating its potential to guide management of high‑risk oral lesions. © 2006 Wiley Periodicals, Inc., Head Neck, 2006.

Abstract

Abstract Background A considerable proportion of oral cancer and precancer is not clinically apparent and could contribute significantly to the late diagnosis and high mortality of oral cancer. A simple method to identify such occult change is needed. Methods Patients in the Oral Dysplasia Clinics at British Columbia are currently being examined with a simple hand‐held device that permits the direct visualization of alterations to autofluorescence in the oral cavity. Tissue showing loss of autofluorescence is biopsied. Results We present 3 representative cases in which occult lesions were identified with fluorescence visualization during longitudinal follow‐up, resulting in the diagnosis of a primary dysplasia in case 1, a second primary cancer in case 2, and cancer recurrence in case 3. Conclusions This is the first report of the diagnosis of occult oral disease using a simple noninvasive device. These early examples indicate the potential value of this technology to guide the management of patients with oral lesions, facilitating the detection of high‐risk changes not apparent with white‐light visualization. © 2006 Wiley Periodicals, Inc. Head Neck, 2006