I have just had a tongue biopsy for a red and white lesion on it that my oral pathologist was sure was lichen planus. The path report says mild to moderate dysplasia. My surgeon claims he got 90% of it, and wants to see me back in a month. I am making him test for HPV, but he seemed rather unconcerned. I really want to just get it all taken out with clear margins.
I have twins who are 2 and am terrified of touching them as they may get HPV. I know it is ubiquitous, but you know kids, they put their hand in your food, etc.
I am a family doc, but we never see this. I am sending my slides to my friend in Boston who is a dermatopathologist and he is getting another opinion from his oral pathologist collegue. I don't smoke and only drink socially, am female and just over 40. Any idea of the prognosis? I am thinking the worse already...

I honestly don't think you spread HPV that way ..by just touching . I am not medical so I don't know. Atleast not the strain that causes cancer.

It isn't bad to get a second opinion and I too would want clear margins. I am young 36 and I didn't smoke and rarley drank and female and NOT HPV ..so it does happen ..... what does he want to do to treat the dysplasia?

Shar

Enigmatic,
I know how you feel having faced the same unknowns ten years ago. You say you are a family Doc. So..I would suggest telling yourself the same things you would tell a patient. Until you have your second opinion and all the information on available and possible treatment options getting all stressed out is only going to harm you.
The mind can be a terrible place to hang out. I wouldn't worry about spreading HPV by touching your children. If a simple touch spread the virus we would all be infected with HPV. You also don't know if your dysplasia is HPV positive. One thing at a time.

Dysplasia of the basement membrane of the tongue is a pre-malignant condition if not treated. How long it takes to transform is different with every case.
I would suggest once the opinions are in that you may want to have wider margins excised to ensure healthy borders.
E-mail me if I can offer any assistance.
Please try and stay positive, your twins need you.
Mike

As you can see from my signature, my husband was initially diagnosed with moderate dysplasia as well, in late April 2006.

When I discovered this website a week or so later, I asked about leukoplakia. Here's how Brian Hill, OCF founder, responded:
[quote]Leukoplakia is a PRE-cancerous condition that does not always move completely into malignancy. Dysplasia are those cells which are no longer normal, but they are not really malignant yet...an in-between state, so to speak.

Dysplasias also do not always go completely over to the dark side, but they are a step in that direction... and having them removed, or watched very regularly, is prudent.

Dysplastic leukoplakias can often return after surgical removal, many times done with a laser, sometimes via a blade excision. Keep an eye on things even after the removal from now until forever. [/quote](The boldface emphasis is mine.)

In my husband's case, it did turn to the dark side but was caught very, very early. When he was younger he did smoke and drink, but he has not done either for decades and his doctor at Johns Hopkins says he considers my husband in the same "category" of patients who never smoked.

We did not have his slides tested for HPV, as the area excised was on the side of his tongue. From what I have read on this site and elsewhere, oral HPV+ SCC is most common in the base of tongue/tonsil area, not on the mobile tongue. I'll be interested to hear the results of your HPV test.

All the best,
Leslie

I want to thank all of you....I was getting a bit crazy over all of this. I have spoken with my dermatologist, and called my surgeon again. The surgeon did tell me that the side was unlikely to be HPV, but he is planing to take more out...he wants to see everything heal as I had 3 wisdom teeth out at the same time. He told me to stop worrying about spreading it to the kids and that now that we know what it is, it is unlikely to get really bad as we will be watching.

Enigmatic,
Sounds like you're in good hands. Your post also leads me to believe that you are a little calmer now that you have talked to some people.
I'm here if you need me.
Take care. Keep us up to date on your progress.
Cheers,

Mike

Enigmatic,

Not much to add here from another dentist. As Mike said, you seem to be in a better mental state and I'm glad to see that. I too had lateral border of the tongue SCC. Never tested for HPV. As Leslie stated, since there is no documented evidence of mobile tongue lesions being positive for HPV.

Good luck and please keep us posted.

Jerry

Well I still have nothing new...I am seeing a head and neck surgeon on Dec.12 for a second opinion. No word on the HPV yet. I have started taking green tea capsules and drinking the stuff...yuck. I also started some vitamins A, B complex and D. I am considering starting Celebrex, but I need to ask a cardiologist about the cardiovascular risks. I never really smoked unless you count a few Cuban cigars on vacation, and I only drank about twice a month, but I will miss red wine. I might have to have some now and again. Oh, and I am trying to drink grape juice. Is there anything else I should be doing?

Sounds like you are on the right track and getting things done. Just one small suggestion about the green tea taste in case it helps: I didn't like it either until I got the kind that comes with lemon in it or I suppose you could add lemon. Hope everything works out the way it should.

Try Tazo brand "Zen" green tea - I drink it every day. It has lemon verbena and a little mint in it - tastes lovely!