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

Head Neck. 2007 Jan;29(1):71-6. doi: 10.1002/hed.20468.


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.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Early Diagnosis
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Luminescent Measurements / instrumentation*
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnosis*
  • Precancerous Conditions / diagnosis*
  • Spectrometry, Fluorescence / instrumentation*