Proliferative verrucous leukoplakia (PVL) is an aggressive form of oral leukoplakia with multifocal presentation, high rates of recurrence and malignant transformation. Although development of regional lymph node metastasis is relatively frequent in patients with oral squamous cell carcinoma, axillary metastasis is quite uncommon. This paper presents a case of a 64-year-old female patient who was diagnosed with PVL and developed five oral squamous cell carcinomas and later an axillary lymph node metastasis.

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