Oral Squamous Papilloma Management with Diode Laser: A Case Report

Introduction: Oral Squamous Papilloma (OSP) is a benign,hyperplastic wart-like localized proliferation, representing anexaggerated growth of normal squamous epithelium causedby Human Papillomavirus (HPV) types 6 and 11. It can occurat any age and is commonly found on the tongue, lips, buccalmucosa and palate.Case report: We present a case of oral squamous papillomain a 40-year-old male patient in the hard palate which wasmanaged by laser excision.Conclusion: Oral Squamous Papilloma is an exophyticnon-contagious growth which is caused by papilloma virus.Surgical excision is the treatment of choice and laser excisionhas shown to be a promising treatment modality with highpatient compliance.

Symptomatic oral squamous papilloma of the uvula – a rare incidental finding

@#Oral squamous papillomas are benign neoplasms of the oral cavity that occur commonly on the palate. Albeit benign and often asymptomatic, they may still cause concern due to their appearance, which may mimic other malignant oral pathologies. Human papillomavirus (HPV) is usually implicated in papilloma pathogenesis. We present a rare case of symptomatic oral squamous papilloma arising from the uvula and causing tongue and throat irritation. This benign lesion was excised with electrocautery.

Papilloma of lip associated with human papilloma viruses‑32 infection in a child.

Squamous papilloma is the most common benign oral epithelial lesion, and it is well known to be associated with human papilloma virus 6 and 11. Here, we report a case of squamous papilloma associated with human papilloma viruses (HPV)‑32 in a 4‑year‑old boy who presented with a verrucous lesion on the lower lip. HPV‑32 is often associated with a rare benign condition focal epithelial hyperplasia (FEH). A limited number of lesions and the absence of characteristic histology ruled out FEH in our patient. To the best of our knowledge, the association of oral squamous papilloma with HPV‑32 is hitherto unreported.

Clinical Features and Surgical Treatment Outcomes of Conjunctival Squamous Papilloma

PURPOSE: To investigate the clinical features, surgical treatments, and their outcomes in conjunctival squamous papilloma. METHODS: A retrospective chart review was conducted on 31 patients with 32 eyes that were treated for conjunctival papilloma from October 2000 to February 2015 in Seoul National University Hospital and Seoul National University Bundang Hospital. RESULTS: Among the 31 patients, 9 patients had papilloma which recurred after previous surgical excision at another hospital. Twenty-five eyes had one papilloma lesion, 2 eyes had 2 lesions, and 5 eyes had more than 3 lesions. The most affected location of papilloma was the tarsal conjunctiva. The recurrent group displayed a tendency to have multiple lesions. Surgical excision without any adjuvant therapy was performed in 13 eyes; surgical excision and cryotherapy in 15 eyes; surgical excision, cryotherapy, and topical interferon alfa-2b in 3 eyes; and surgical excision and amniotic membrane transplantation in 1 eye. The mean postoperative follow up period was 11.1 months. There were 5 cases of recurrence and the mean time of recurrence after surgical excision was 4.22 months (range, 3 days to 9 months). Among 5 cases of recurrence, 3 cases were after surgical excision only, 1 case was after surgical excision and cryotherapy, and 1 case was after surgical excision, cryotherapy, and topical interferon alfa-2b. These 5 recurred cases were retreated with surgical excision and cryotherapy, surgical excision and topical interferon alfa-2b, or surgical excision, cryotherapy, and topical interferon alfa-2b. CONCLUSIONS: Conjunctival squamous papilloma is likely to recur even though the tumor is completely removed. Therefore, long-term postoperative follow up may be necessary for recurrence.

Oral Squamous Papilloma with Dysplastic Features

Squamous papillomas are common lesions of the oral mucosa with a predilection for the mucosa of the hard and soft palate. As an oral lesion, it raises concern because of its clinical appearance, which may mimic exophytic carcinoma, verrucous carcinoma or condylomaacuminatum. Its pathogenesis is related to human papilloma virus but there is controversy regarding its viral origin. We present a case of squamous papilloma with moderate dysplasia presenting as oral lesion.

Crioterapia en pacientes con papiloma escamoso bucal / Cryotherapy in patients with oral squamous papilloma

Se efectuó un estudio descriptivo y transversal de 58 pacientes con papiloma escamoso bucal, atendidos en la consulta estomatológica del Policlínico de Especialidades del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde febrero del 2008 hasta igual mes del 2013, con vistas a evaluar los resultados terapéuticos de la criocirugía en estos afectados. Para la remoción de esta enfermedad se aplicó nitrógeno líquido por su gran poder refrigerante. La evaluación del tratamiento crioquirúrgico se estableció mediante la medición del tiempo de congelación y descongelación, con predominio de 20-30 segundos para la primera y 91-120 para la segunda. La reparación y reepitelización de los tejidos bucales ocurrió entre los 7 y 14 días de practicada dicha modalidad terapéutica, la cual resultó ventajosa por ser de fácil aplicación, atraumática, sin riesgo ni complicación e inocua en la mucosa bucal.

A descriptive and cross sectional study of 58 patients with oral squamous papilloma, assisted in the Stomatological Department of the Specialties Polyclinic from "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba was carried out from February, 2008 to the same month of 2013, with the aim of evaluating the therapeutic results of the cryosurgery in these affected patients. For the removal of this disease, liquid nitrogen was applied due to its great coolant power. The evaluation of the cryosurgical treatment was established by measuring the freezing and unfreezing time, with prevalence of 20-30 seconds for the first one and 91-120 for second one. The repair and reepitelization of the oral tissues took place between the 7 and 14 days of having applied this therapeutic modality, which was advantageous as it is easily applied, it causes no trauma, it has neither risk nor complication and it is innocuous in the oral mucous.

Angioleiomyoma of the Nasal Cavity

Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis...

A Case of Intralesional Cidofovir Injection for Recurrent Lacrimal Sac Squamous Papilloma

PURPOSE: To report a case of treating a patient with intralesional cidofovir injection who had frequently recurring lacrimal sac squamous papilloma after several excision surgeries. CASE SUMMARY: A 59-year-old man who had mass excision surgery at a different clinic nine months previously, visited our clinic to treat a recurring erythematous protruding mass near his left medial canthus that developed two months prior. Orbit CT showed a 15 x 25 mm-sized large mass located on the lacrimal sac adherent to medial orbital wall. An excision biopsy was performed and the histopathologic examination showed typical findings of squamous papilloma. Because the tumor recurred six months after the second surgery, we decided to perform adjuvant therapy using the antiviral agent cidofovir. The patient was treated with a 5 mg/mL intralesional cidofovir injection every three weeks. A transient recurrence presented on the upper lid at the third intralesional cidofovir injection site two months after the surgery, but the recurrent lesion improved after repeated injections. During the 12 months of follow-up, there were no complications and no evidence of recurrence. CONCLUSIONS: Intralesional cidofovir injections can be a safe and effective treatment for the management of recurrent squamous papilloma of the orbit, especially after total excision.

Estudo de p27, p21, p16 em epitélio escamoso normal, papiloma escamoso e carcinoma de células escamosas da cavidade oral / Comparative analysis of the immunohistochemistry expression of p27, p21WAF/Cip1, and p16INK4a in oral normal epithelium, squamous papilloma and squamous cell carcinoma

INTRODUÇÃO E OBJETIVO: O tipo de câncer oral mais frequente é o carcinoma de células escamosas, que corresponde a 95 por cento dos casos(9). O papiloma escamoso oral é uma neoplasia benigna normalmente associada à infecção pelo papilomavírus humano (HPV)(21). A análise da literatura mostra alterações nos genes reguladores do ciclo celular p27, p21WAF/Cip1 e p16INK4a, porém sem uma definição de seus papéis na carcinogênese oral. O objetivo foi caracterizar imuno-histoquimicamente p27, p21WAF/Cip1 e p16NK4a em epitélio escamoso normal, papilomas escamosos e carcinomas de células escamosas da cavidade oral. MÉTODOS: Imuno-histoquímica para p27, p21WAF/Cip1 e p16NK4a em 32 casos de epitélio escamoso normal, 30 casos de papiloma escamoso e 34 de carcinoma de células escamosas da cavidade oral. RESULTADOS: p27: 97,06 por cento dos casos de carcinoma de células escamosas apresentaram imunopositividade focal. O grupo papiloma escamoso apresentou 33,33 por cento e o grupo controle, 18,75 por cento. p21WAF/Cip1: 100 por cento de imunopositividade focal tanto no grupo controle como no grupo carcinoma de células escamosas, e 90 por cento no grupo papiloma escamoso. p16INK4a: 100 por cento de imunopositividade focal para os grupos controle e papiloma escamoso, e 94 por cento para o grupo carcinoma de células escamosas. CONCLUSÃO: Imuno-histoquimicamente demonstrou-se diferença significativa para p27 quando feita comparação dos grupos controle e papiloma escamoso com o grupo carcinoma de células escamosas. O p21WAF/Cip1 não demonstrou poder de diferenciar os grupos analisados. O p16INK4a apresentou imunopositividade difusa em uma minoria dos casos do grupo carcinoma de células escamosas. O grupo papiloma escamoso se comportou de maneira similar ao grupo controle em relação aos três marcadores.

INTRODUCTION: The most frequent type of oral cancer is the squamous cell carcinoma, which corresponds to 95 percent of the cases(9).The oral squamous papilloma is a benign neoplasia, commonly associated with infections caused by the human papilloma virus(21). The analysis of medical literature shows changes in cell cycle regulatory genes (p27, p21WAF/Cip1 and p16INK4a), but does not define their roles in oral carcinogenesis. Objective: Characterize the immuno-histochemical expression of p27, p21WAF/Cip1 and p16INK4a in oral normal squamous epithelium, oral squamous papilloma and oral squamous cell carcinoma. METHODS: Immuno-histochemical evaluation of p27, p21WAF/Cip1 and p16INK4a in 32 samples of oral normal squamous epithelium, 30 of oral squamous papilloma and 34 of oral squamous cell carcinoma. RESULTS: 97.06 percent of the oral squamous cell carcinoma group, 33.33 percent of the squamous papilloma group and 18.75 percent of the control group showed focal immunopositivity for p27. 100 percent of both control and oral squamous cell carcinoma groups and 90 percent of the oral squamous papilloma group showed focal immunopositivity for p21WAF/Cip1. 100 percent of both control and oral squamous papilloma groups and 94 percent of the oral squamous cell carcinoma group showed focal immunopositivity for p16INK4a. CONCLUSIONS: The study revealed a statistically significant difference for p27 expression when comparing the control and oral squamous papilloma groups with the oral squamous cell carcinoma group. p21WAF/Cip1 did not prove to be useful to differentiate the groups. p16INK4a showed diffuse immunopositivity in a minority of the oral squamous cell carcinoma cases. The oral squamous papilloma group behaved similarly to the control group as to the three markers.

The Effect of Topical Interferon alpha-2b in the Treatment of Conjunctival Squamous Papilloma

PURPOSE: To study the effectiveness of Interferon alfa-2b (IFN alpha 2b) for treating squamous papilloma of the conjunctiva. METHODS: One million units/cc of IFN alpha 2b was applied 4 times a day after identifying squamous papilloma by excisional biopsy. The IFN alpha 2b was used continuously 2 to 6 months after the tumor became undetectable with the unaided eye. The dose was then tapered. RESULTS: Three of the 4 patients had a history of recurrences (1-4 times). In one patient, the tumor was difficult to remove surgically due to the location of the tumor (around the upper punctum). The tumor disappeared with no complications or recurrences during the follow-up period. CONCLUSIONS: In patients with conjunctival squamous papilloma with frequent relapses or difficulty in excision, applying IFN alpha 2b as an eye drop appears to be an effective form of therapy and can be used safely without complications.

A Case of Squamous Papilloma in Oral Mucosa / 대한피부과학회지

Squamous papilloma is a commom benign lesion of the oral mucosa, but rarely encountered in dermatologic practice. Usually, oral squamous papilloma is a solitary peduculated lesion with verrucous surface, and known to be associated with human papilloma virus (HPV). We experienced a histologically confirmed case of oral squamous papilloma which occured in a 54-year-old man.

Diagnostic problem of squamous papilloma and oral mucosa malignancy

Squamous papilloma is a benign proliferation of stratified squamous epithelium, resulting in a papillary or verruciform mass. Verrucous carcinoma is a differentiated variant of squamous cell carcinoma and may present diagnostic difficulties as it may be erroneously diagnosed as squamous papilloma. Squamous papilloma is similar to other oral mucosa malignancy in microscopic view. So, it is difficult to distinguish between squamous cell papilloma and other oral mucosa malignancy. Here are three patients. they were diagnosed as squamous papilloma initially, but the lesion was recurred. In recurred lesion, verrucous carcinoma or squamous cell carcinoma were found. So we report that recurred oral mucosa malignency(verrucous carcinoma or squamous cell carcinoma) which was diagnosed as squamous papilloma.

A Case of Squamous Papilloma in the Middle Ear, External Auditory Canal, and Infratemporal Fossa / 대한이비인후과학회지

Papilloma is a benign neoplasm confined almost exclusively to the sinonasal tract. And rare cases involving middle ear or external auditory canal, usually extended or contaminated from nasal cavity have been reported. We recently experienced a case of squamous papilloma involving middle ear, external auditory canal, and infratemporal fossa without any evidence of involving sinonasal tract. We present a review of literature and discuss the pathophysiology of the papilloma.

Correlation between Squamous Papilloma and Human Papillomavirus in Esophagus / 대한소화기내시경학회지

BACKGROUND/AIMS: Esophageal squamous papillorma is a rare benign lesion. This lesion is generally asymptomatic and solitary. Resent studies reveal the presence of human papil- lomavirus in certain cases of esophageal squamous papilloma, and human papillomavirus appears to be pathogenetically related to the esophageal squamous papilloma. The aim of this study was to evaluate the presence of human papillomavirus in esoplmgeal spuamous papilloma. METHODS: In situ hybridizations and direct in situ polymerase chain reactions for human papillomavirus type 6/11 were performed on 16 paraffin embedded tissues with esophageal squamous papilloma. RESULTS: Human papillomavirus type 6/11 was detected in 1 of 16 esophageal squamous papillomas on direct in situ polymerase chain reaction. All lesions were solitary, and 12 of 16 cases were located in distal one-third of the esophagus. Age range was 23-71 years (mean, 41 years). CONCLUSION: These results indicate that causal relation between human papillomavirus type 6/11 and esophageal squamous papilloma is inconspicuous.

In situ hybridization study on human papillomavirus DNA expression in benign and malignant squamous lesions of the esophagus

Histologic changes suggesting HPV infection are occasionally found adjacent to squamous cell carcinoma or in squamous papilloma of the esophagus, but the relationship between HPV infection and benign and malignant squamous lesions of the esophagus is not yet dear. The aim of this study was to examine the role of HPV in squamous lesions of the esophagus. Microscopic examination with emphasis on HPV infection was done on 15 cases of squamous cell carcinoma and 26 cases of squamous papilloma. In situ hybridization technique for wide-spectrum HPV probe was performed on 35 endoscopically biopsied esophageal tissues. Among the histologic parameters suggesting HPV infection, acanthosis was the most frequent finding: 100.0% in benign and malignant esophageal lesions, and koilocytosis and intraepithelial capillary loops were the second (92.7%).: Dyskeratosis, basal cell hyperplasia and bi- or multinucleation were 52.3%, 44.0% and 34.1% in frequency, respectively. On in situ hybridization study, the HPV DNA expression rates of 10 squamous cell carcinomas with evidence of HPV infection and 15 carcinomas without evidence of HPV infection were 60.0% and 33.3%, respectively. In contrast to the carcinoma cases, only one (10.0%) of 10 squamous papillomas revealed positive signal. In conclusion, HPV infection is strongly associated with squamous cell carcinoma, but the causal relation of HPV to squamous papilloma is inconspicous.

In situ hybridization study on human papillomavirus DNA expression in benign and malignant squamous lesions of the esophagus

Histologic changes suggesting HPV infection are occasionally found adjacent to squamous cell carcinoma or in squamous papilloma of the esophagus, but the relationship between HPV infection and benign and malignant squamous lesions of the esophagus is not yet dear. The aim of this study was to examine the role of HPV in squamous lesions of the esophagus. Microscopic examination with emphasis on HPV infection was done on 15 cases of squamous cell carcinoma and 26 cases of squamous papilloma. In situ hybridization technique for wide-spectrum HPV probe was performed on 35 endoscopically biopsied esophageal tissues. Among the histologic parameters suggesting HPV infection, acanthosis was the most frequent finding: 100.0% in benign and malignant esophageal lesions, and koilocytosis and intraepithelial capillary loops were the second (92.7%).: Dyskeratosis, basal cell hyperplasia and bi- or multinucleation were 52.3%, 44.0% and 34.1% in frequency, respectively. On in situ hybridization study, the HPV DNA expression rates of 10 squamous cell carcinomas with evidence of HPV infection and 15 carcinomas without evidence of HPV infection were 60.0% and 33.3%, respectively. In contrast to the carcinoma cases, only one (10.0%) of 10 squamous papillomas revealed positive signal. In conclusion, HPV infection is strongly associated with squamous cell carcinoma, but the causal relation of HPV to squamous papilloma is inconspicous.

Clinical Feature of Esophageal Papilloma / 대한소화기내시경학회지

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.