Papilloma

Papilloma
Other names	Papillomas, papllomata, papillomatous tumo[u]r
Intraductal papilloma of breast, H&E stained, 10×
Specialty	Oncology

A papilloma (plural papillomas or papillomata) ( papillo- + -oma ) is a benign epithelial tumor ^[1] growing exophytically (outwardly projecting) in nipple-like and often finger-like fronds. In this context, papilla refers to the projection created by the tumor, not a tumor on an already existing papilla (such as the nipple).

When used without context, it frequently refers to infections (squamous cell papilloma) caused by a human papillomavirus (HPV), most commonly in the form of warts. Human papillomavirus infections are a major cause of cervical cancer, vulvar cancer, vaginal cancer, penile cancer, anal cancer, and HPV-positive oropharyngeal cancers. ^{[2] [3] [4] [5] [6]} Most viral warts are caused by human papillomavirus infection (HPV). ^[7] There are nearly 200 distinct human papillomaviruses (HPVs), ^[4] and many types are carcinogenic. ^{[2] [3]} There are, however, a number of other conditions that cause papillomas, and in many cases the cause may be uncertain.

Signs and symptoms

HPV6 pedunculated papilloma behind the uvula, and HPV6 sessile (flat) papilloma next to the uvula

HPV6 pedunculated papilloma removed from behind the uvula using a laser

A benign papillomatous tumor is derived from epithelium, with cauliflower-like projections that arise from the mucosal surface. It may appear white or normal-colored. It may be pedunculated or sessile. The typical size range is 1–5 cm. Neither sex is significantly more likely to develop papillomas. The most common site is the palate–uvula area, followed by tongue and lips. Durations range from weeks to 10 or more years.

Presence of HPV

Immunoperoxidase stains have identified antigens of the human papillomavirus (HPV) types 6 and 11 in approximately 50% of cases of squamous cell papilloma. ^[8]

Prognosis

There is no evidence that papilloma tissue is itself premalignant, despite HPV's frequent connection to later development of cancers.^{[ citation needed ]}

Differential diagnosis

Other conditions which may present similar symptoms (and which are also caused by HPV infections) include:

• Intraoral verruca vulgaris (common warts)
• Condyloma acuminatum (genital warts)
• Focal epithelial hyperplasia (oral warts)

Differentiation is done accurately by microscopic examination.

Treatment

With conservative surgical excision, recurrence is rare.^{[ citation needed ]}

See also

• Skin tag
• Inverted papilloma
• Squamous cell papilloma
• Urothelial papilloma
• Intraductal papilloma of breast
• Wart
  • Genital wart
  • Plantar wart
• Papillomavirus
  • Human papillomavirus

References

1. "papilloma" at Dorland's Medical Dictionary
2. Muñoz, N.; Bosch, F. X.; de Sanjosé, S.; Herrero, R.; Castellsagué, X.; Shah, K. V.; Snijders, P. J.; Meijer, C. J.; et al. (International Agency for Research on Cancer Multicenter Cervical Cancer Study Group) (February 2003). "Epidemiologic classification of human papillomavirus types associated with cervical cancer". The New England Journal of Medicine. 348 (6): 518–527. doi:10.1056/NEJMoa021641. hdl: 2445/122831 . PMID   12571259. S2CID   1451343.
3. Parkin, D. M. (June 2006). "The global health burden of infection-associated cancers in the year 2002". International Journal of Cancer. 118 (12): 3030–3044. doi: 10.1002/ijc.21731 . PMID   16404738. S2CID   10042384.
4. Ljubojevic, S.; Skerlev, M. (2014). "HPV-associated diseases". Clinics in Dermatology. 32 (2): 227–234. doi:10.1016/j.clindermatol.2013.08.007. PMID   24559558. S2CID   24219797.
5. "Human papillomavirus (HPV) and cervical cancer". WHO.int. World Health Organization. June 2016. Archived from the original on 5 August 2016.
6. Jamal, Zohaib; Anjum, Fatima (January 2024). "Oropharyngeal Squamous Cell Carcinoma". Treasure Island, Florida: StatPearls Publishing. doi:10.32388/G6TG1L. PMID   33085415 – via US National Center for Biotechnology Information.
7. "Warts: Overview" (Updated ed.). US National Library of Medicine. 4 May 2017 [30 July 2014]. Archived from the original on 10 September 2017. Retrieved 7 February 2021.
8. Quinlan, Jeffrey D. (August 2021). "Human Papillomavirus: Screening, Testing, and Prevention". American Family Physician. 104 (2): 152–159. ISSN   1532-0650.

External links

• Choroid Plexus Papilloma - Palmer, Cheryl Ann and Daniel Keith Harrison; EMedicine; 5 June 2008