Ackerman’s Tumor and Field Cancerization with Emphasis on Chemoprevention

Abstract

Slaughter et al (1953) coined the term ‘field cancerization’ for the mucosa of head and neck region undergoing genetic transformation directly proportional to the intensity and duration of carcinogen exposure, making it more susceptible to develop many foci of premalignant lesions and malignant transformation. This increases the overall incidence and variety of oral cancers we encounter in our day-to-day practice. We describe a patient with an exophytic oral lesion diagnosed as verrucous carcinoma, who was already undergoing treatment, regular follow-up and recovering well from speckled leukoplakia. The lesion was completely excised. The patient subsequently developed leukoplakias in the affected field which histopathologically showed mild to moderate dysplasia. This case shows that mucosa was breaking at different points into different premalignant lesions and neoplasm, in spite of patient’s abstinence from the habit and regular treatment with meticulous follow-up, chemoprevention is also briefly reviewed. This report highlights two important aspects: (1) Site-specific treatment is not adequate and (2) Regular, close and meticulous follow-up is important for high-risk patients.