A case of oropharyngeal squamous papilloma in which endoscopic resection was performed

Abstract

A 56-year-old woman was referred to Hokkaido University Hospital for endoscopic resection of a tumor in the oropharynx. Further endoscopic examination revealed a lesion with a characteristic verrucous appearance reminiscent of papillomatous warts seen on the skin and esophagus (Fig. 1A). Magnified narrow-band imaging showed that microvessels in the lesion were not dilated (Fig. 1B). The lesion was diagnosed as an oropharyngeal squamous papilloma. Endoscopic resection was selected as treatment. Written informed consent was obtained after we explained the advantages and risks and before we initiated treatment. The endoscopic resection procedure was performed with the patient under conscious sedation by using a total of 10 mg diazepam. An endoscope (EG 450 RDS; ToshibaFujinon, Tokyo, Japan) and an electrosurgical current generator (ICC200; Erbe, Germany) were used for the procedure. Before resection, a total of 1.5 mL of 1% lidocaine was injected under the lesion to prevent pain during the resection and to obtain mucosal elevation. Endoscopic resection was performed by use of snare polypectomy, with the generator set at 120 W for endocut effect 3 mode, and a 40-W current for forced coagulation mode was used for additional coagulation to prevent hemorrhage (Fig. 2). The procedure was completed in 12 minutes. The patient did not report pain or a burning sensation during the resection. Postoperative pain was controlled without using an analgesic. The patient was allowed to eat soft food on the day after resection and was discharged 2 days after resection. The lesion in the resected specimen was 0.7 0.4 cm in size. Histologic diagnosis revealed a squamous papilloma with negative margins (Fig. 3).