Should I be concerned?

[Chirping66]

Hi, in Jan 2020 I had a small 2x4 mm white papillated plaque spot on facial papilla #3,4 removed for biopsy that had been there about a year. It came back as hyperkeratotic squamous epithelium exhibiting areas of verrucous hyperplasia. Negative for dysplasia.
No other recurring spots on that side since removal.
last month I noticed another circular white spot in the same area but on the other side of my mouth on the upper gums. It was removed for biopsy last week and I’m awaiting results.
my concern is this. My periodontist told me he was not concerned about the verrucous hyperplasia spot removed last year and he said he is not worried at all about the latest spot removed on the opposite side. There isn’t a lot of documentation on hyperplasia other than some studies saying it can be pre malignant. Should I be worried that my periodontist is not concerned about it? I’m worried it’s being under diagnosed and could be verrucous carcinoma.
Thanks

 

[Dr M]

Good day
If the lesion is biopsied, the histological results will reveal if dysplasia is present or not. Although the periodontist cannot say from a clinical appearance only if dysplasia is present, there are certain clinical presentations which make a lesion more likely to appear malignant.
Wait for the biopsy report. Every report should give an indication of the lesion is dysplastic or not. If no dysplasia is present, then you don't need to worry.

 

[Chirping66]

Good day
If the lesion is biopsied, the histological results will reveal if dysplasia is present or not. Although the periodontist cannot say from a clinical appearance only if dysplasia is present, there are certain clinical presentations which make a lesion more likely to appear malignant.
Wait for the biopsy report. Every report should give an indication of the lesion is dysplastic or not. If no dysplasia is present, then you don't need to worry.

Thank you, I got the results today and it came back as verrucous hyperplasia. No dysplasia was found. I understand that means no dysplasia means no atypical cells which is good. But everything I have read says verrucous hyperplasia should be treated as verrucous carcinoma as they are both indistinguishable. Should I be worried since this is my second verrucous hyperplasia spot in two different places over the last year and a half?

Thanks

 

[Dr M]

This is meant in terms of diagnoses. They look clinically similar, and this is why you do a biopsy.After the biopsy, they are distinguishable. If no dysplasia is present, observe the lesion for any changes in the future.