Case Of Papilloma Research Articles

Single Agent Therapy with Bevacizumab for the Treatment of Atypical Choroid Plexus Tumor

Introduction Choroid plexus tumors are rare tumors of the brain. They account for 0.3-0.6% of all brain tumors. Fifty percent of these tumors occur in the lateral ventricle, 40% in the fourth ventricle, 5% in the third ventricle, and 5% are multifocal. Grading of choroid plexus tumors is based on World Health Organization (WHO) classification. Choroid plexus papilloma is grade I, atypical choroid plexus papilloma is grade II, and choroid plexus carcinoma is grade III. For both choroid plexus papilloma and choroid plexus carcinoma, age at presentation correlates with the location of the tumor. Lateral ventricle tumors are more common in children less than 10 years old, while fourth ventricle tumors are distributed evenly up to 50 years of age. Choroid plexus papilloma is welldifferentiated and usually has a benign course and carries a good prognosis after complete resection. Occasionally, there can be a malignant transformation to a choroid plexus carcinoma at recurrence. These are aggressive tumors characterized by brisk mitotic activity, increased cellularity, nuclear pleomorphism, focal necrosis, loss of papillary architecture, and invasion of neural tissue. Presenting symptoms often are related to cerebrospinal fluid obstruction, such as headache, diplopia, and ataxia. We present a rare case of atypical choroid plexus papilloma in an adult who was treated with single agent chemotherapy. Case Report A 52-year-old woman was referred for chemotherapy of recurrent atypical choroid plexus papilloma. She initially was diagnosed with choroid plexus papilloma and underwent resection. The tumor recurred on multiple occasions and the patient was treated with surgery (three resections) and stereotactic radiosurgery. The last surgery was thirteen years post diagnosis. The pathology result was positive for atypical choroid plexus papilloma (Figure 1). Her last MRI (Figure 2) showed the recurrence of the tumor in the pons area. Due to the location of the tumor, she was not recommended for surgery and referred to medical oncology for systemic chemotherapy. At relapse, the patient complained of headaches and neuropathic pain in the right neck when rotated. She also had right facial nerve palsy with numbness secondary to previous surgeries.

树鼩乳腺导管内乳头状瘤一例

报告一例树鼩乳腺导管内乳头状瘤。患病树鼩为雌性，3岁。肿块位于腹部皮下乳腺部位，直径约为1.0 cm，椭圆形不规则，表面光滑。组织病理学观察发现肿块含有乳腺特有的乳腺终末导管结构和少量乳腺小叶结构，由导管乳头和小叶状增生细胞组成，乳头分支少，较为粗大，细胞体积较大，细胞界限清晰，核分裂少见，伴有大汗腺样化生。核仁明显，细胞核位于细胞中央一侧，胞浆丰富并且呈红色，伴有坏死。诊断为乳腺导管内乳头状瘤。 A case of breast intraductal papilloma of tree shrews is described. Masses in the breast area were found in a 3-year-old female tree shrew. The lump diameter is about 1 cm, irregular oval and smooth surface. Histopathological examination with H.E staining showed that mass contained breast specific terminal ductal structures and a small amount of breast lobules, which was composed of ductal papillary and lobular hyperplasia. The nipple was less branching and more bulky; the cell volume was bigger; the cell boundary was clear; the nuclear division was rare, and accompanied by sweat gland metaplasia. The nucleus is located in the side of the cell, and the cytoplasm is rich and red with necrosis. The pathological feature of case supported the diagnosis of breast intraductal papilloma.

Diode laser treatment of an oral squamous papilloma of soft palate

Oral squamous papilloma is one of the most common benign epithelial neoplasm, frequently seen on the tongue, palate, uvula, and gingiva; and found to be associated with human papillomavirus (HPV) 6 and 11. Treatment laser-assisted surgery is common because of several advantages such as successful hemostasis, devoid of sutures, wound sterilization, and minimal postoperative pain and edema. The aim of this report is to present the case of oral squamous papilloma of the soft palate in a 57-year-old male patient and its management with a diode laser.

Pigmented Extraventricular Choroid Plexus Papilloma – Case Report and Review of Literature

Pigmented Extraventricular Choroid Plexus Papilloma – Case Report and Review of Literature Choroid plexus papilloma (CPP) is rare slow growing tumor that is usually located in ventricular system. We report a case of extraventricular melanotic choroid plexus papilloma in a 65 year old female. This patient underwent successful microsurgical resection.

ソナゾイド造影エコーが有効であった両側乳管内乳頭腫の1例

症例は80歳の閉経後女性．両側乳管内乳頭腫の診断で経過観察中に増大傾向を認め精査となった．造影MRIで右乳腺腫瘍は充実性部分の評価が困難で，左乳腺腫瘍は不整で悪性の造影パターンであった．US・造影MRI所見で両側ともに悪性が疑われたが，超音波造影剤Sonazoid®による造影エコーで右乳腺腫瘍は嚢胞内に均一な造影効果を伴う充実性部分を同定でき，左乳腺腫瘍は腫瘤内に限局して均一な造影を認め，良性が示唆された．術前針生検では良性との診断で両側腫瘍摘出術を施行し，病理結果は両側ともに乳管内乳頭腫と診断された．術前診断としてUSや造影MRIで評価困難であった乳管内乳頭腫症例に対し，造影エコーが有効であった症例を経験したため，文献的考察を含め報告する．

Long-Term Evaluation of Tumor Removal at the Eyelid Margin Using a Radio-Frequency Electrosurgical Unit

Purpose: To evaluate the long-term follow-up results of the eyelid margin tumor resection using a radio-frequency electrosurgical unit. Methods: We retrospectively reviewed the medical records of 53 patients (55 eyes) diagnosed with eyelid margin tumor and who underwent eyelid tumor resection using a radio-frequency electrosurgical unit more than 5 years prior. Age, gender, undergoing a biopsy, recurrence,and complications were examined through phone questions and the out-patient department. Results: The study included 23 eyes of 22 males and, 32 eyes of 31 females, (age range 8.6-76.8 years). Surgical success rate was 95% (52 of 55 eyes) and mean follow-up period was 8.9 years. Thirty-four of 55 patients underwent a biopsy, and the most common cases were intradermal nevus and compound nevus (13 cases each), 2 cases of basal cell carcinoma (5.9%), 2 cases of actinic keratosis (5.9%), and, 2 cases of chronic inflammation (5.9%). Other cases included 1 case of squamous papilloma (2.9%) and 1 case of fibrosis (2.9%). There were 3 cases of recurrence. Eyelash-related complications after surgery occurred in 3 cases of trichiasis or distichiasis. Conclusions: Eyelid margin tumor resection using a radio-frequency electrosurgical unit is simple and showed high success rate. Additionally, it is considered as an effective method in the eyelid margin tumor resection due to low recurrence and complication rates in the long-term follow-up. J Korean Ophthalmol Soc 2015;56(8):1149-1153

Pediatric inverted papilloma of the middle ear: Case report and review of the literature

Abstract Inverted papilloma of middle ear is a very rare clinical entity. It has been reported only in the adult population. We report a middle ear inverted papilloma in an 11-year-old male. To the best of our knowledge it is the first pediatric inverted papilloma of middle ear. The patient had a history of chronic suppurative otitis media and the lesion was found during preoperative evaluation for a tympanoplasty procedure. Total excision of the lesion and a tympanoplasty operation was accomplished. We reviewed the middle ear inverted papilloma cases regarding the age distribution, pathophysiology, treatment and prognosis.

Papillary Lesions of the Breast: Outcomes of 156 Patients Managed without Excisional Biopsy

Papillomas of the breast are benign epithelial neoplasms. Because of the low, but continued potential for malignancy, the treatment options after initial diagnosis remain controversial. The aim of this study was to analyze the clinical course of patients with papilloma who were managed by active surveillance following initial diagnosis by core needle biopsy or vacuum-assisted biopsy. This retrospective study analyzed 174 patients with 180 papillomas that were diagnosed by core needle biopsy (113 cases) or vacuum-assisted biopsy (67 cases) at the Breast Center Seefeld Zurich between February 2002 and May 2011. We excluded 24 cases that underwent excisional biopsy for removal of the lesion. Over a mean follow-up of 3.5 years, 13 further events occurred in 156 cases (8%). These events included two cases of ductal carcinoma in situ (one after 4 and one after 6 years), one case of atypical ductal hyperplasia, one radial scar, eight cases of papilloma, and one case of flat epithelial atypia. No invasive carcinomas occurred during the follow-up period. Conservative management of 156 papillary lesions with removal by vacuum-assisted biopsy and surveillance was not associated with invasive cancer over a median follow-up of 3.5 years. Therefore, this approach seems to be a safe option for the clinical management of papillary lesions.

Intraductal papilloma in an axillary lymph node of a patient with human immunodeficiency virus: a case report and review of the literature

IntroductionInclusions of ectopic breast tissue in axillary lymph nodes are reported very infrequently and typically are only identified microscopically as an incidental finding. Furthermore the development of a benign proliferative lesion in the form of an intraductal papilloma from intranodal ectopic breast tissue is an extremely rare phenomenon with only three previous cases reported. This report describes an unusual and rare case of an intraductal papilloma arising in an axillary lymph node of a patient known to have the human immunodeficiency virus.Case presentationA 40-year-old Black African woman underwent excision of an enlarged palpable axillary lymph node. In the preceding 7 years she had received at least six separate surgical excisions to her ipsilateral breast for papillomatosis. The last surgical intervention was performed 1 year prior to presentation with an enlarged axillary lymph node. Histological examination of her axillary lymph node revealed a papillomatous proliferative epithelial lesion within an apparent encompassing duct, resembling a mammary intraductal papilloma. In the surrounding lymphoid tissue small groups of duct-like structures were additionally noted. Immunostaining with a panel of myoepithelial markers in conjunction with oestrogen receptor produced a mixed heterogeneous staining pattern in both the papillomatous lesion and the peripheral duct-like structures. This confirmed the diagnosis of a benign intraductal papilloma within an axillary lymph node, considered to have arisen from ectopic breast tissue.ConclusionsThis case demonstrates that intranodal ectopic breast tissue has the potential to undergo benign proliferative change albeit extremely rarely. Therefore this possibility must be considered to ensure the correct diagnosis is made. In addition, to the best of our knowledge, this is the first case report which has described recurrent intraductal papillomas and the subsequent development of an intraductal papilloma within an ipsilateral axillary lymph node, in a patient who is human immunodeficiency virus positive. There is minimal literature investigating the specific types of breast pathologies experienced by patients infected with human immunodeficiency virus and it remains unexplored as to whether human immunodeficiency virus may lead to proliferative papillomatous epithelial changes. This report considers the role of the human papillomavirus and recommends that further investigatory studies are required.

Large nasopharyngeal inverted papilloma presenting with rustling tinnitus

Tinnitus is a common symptom caused by numerous diseases. The etiology is unknown in most cases; however, nasopharyngeal lesions may cause a certain tinnitus. We herein report a case of nasopharyngeal inverted papilloma which presents with rustling tinnitus as the sole initial symptom. The tympanic membrane was intact, and results of hearing test and impedance audiometry were normal. However, sonotubometry showed a complete blockage of the Eustachian tube. A large tumor was found that originated from the choana and occupied the nasopharynx which caused a rustling sound when she swallowed or spoke. Tinnitus totally subsided after removal of this tumor. To our knowledge, the tumor origin and presenting symptom of this case are very rare, and nasopharyngeal examination is required in the diagnosis of unknown hearing symptoms.

Mixed Squamous Cell and Glandular Papilloma of the Lung in a 64-Year-Old Woman

Mixed squamous cell and glandular papilloma of the lung is an extremely rare benign epithelial tumor showing a mixture of squamous and glandular epithelium. Here, we report a case of mixed squamous cell and glandular papilloma that presented as a solitary nodule in the left lower lobe of a 64-year-old woman. Chest computed tomography demonstrated a lobulated mass in the basal segment of the left lower lobe. The patient underwent a lobectomy under the suspicion of lung malignancy. The histopathological diagnosis was mixed squamous cell and glandular papilloma.

Cytological diagnosis of ductal papilloma with apocrine hyperplasia of breast

Intraductal papillomas of the breast are relatively rare benign lesions with an incidence of approximately 2-3% commonly seen in 20 - 40 years aged women and are rare after 50 years of age. We here in report a case of intraductal papilloma of breast in a 66 year old female with significant family history of breast carcinoma which is a rare presentation. She presented with bloody nipple discharge from right breast since one month. On examination, right nipple is enlarged up to 0.8cm in diameter. Mammogram showed no abnormality. Fine needle aspiration cytology (FNAC) of the enlarged nipple was done and a diagnosis of duct papilloma with apocrine hyperplasia was made. This case report emphasizes the role of FNAC in diagnosing this lesion and relieving the patient from physical and mental trauma at an early stage

Two Cases of the Inverted Papilloma in the Maxillary Sinus Treated by Modified Transnasal Endoscopic Medial Maxillectomy

반전성 유두종은 비강 및 부비동에 발생하는 모든 종양의 0.5~4%를 차지하는 비강의 양성 종양 중에서 가장 흔한 종양 이다. 병리학적으로는 양성이나 골 파괴, 수술 후 높은 재발률, 악성 종양과의 연관성 등으로 임상적으로는 악성 종양과 같이 취급되고 있다. 이러한 종양의 특성 때문에 과거에는 비외접근법을 통한 상 악골 내측절제술과 같은 광범위한 수술이 최선의 치료법으로 생각되어 왔으나, 최근 비강 및 부비동의 수술에 비내시경이 널 리 이용되면서 반전성 유두종의 수술에도 내시경을 이용한 절 제술이 가장 흔히 이용되고 있으며 고식적인 수술의 경우와 유사한 치료 성적을 거두고 있다. 경비강 내시경하 상악골 내 측절제술(transnasal endoscopic medial maxillectomy, TEMM)은 상악동에서 기원한 반전성 유두종의 효과적인 수술적 치료법이나 하비갑개와 비강 측벽, 비루관을 제거하기 때문에 위축성 비염, 빈코 증후군(empty nose syndrome), 과도한 가 피형성, 유루증 등 여러 부작용을 야기할 수 있다. 최근 이러 한 부작용을 피하기 위해 하비갑개와 비루관을 보존하는 변 형 경비강 내시경하 상악골 내측절제술(modified TEMM)이 소개되었으며, 상악동에서 기원한 반전성 유두종의 성공적인 치료결과를 보고하였다. 우리나라에서 반전성 유두종을 변형 경비강 내시경하 상악 골 내측절제술을 이용해 성공적인 치료 결과를 보고한 경우는 없었다. 최근 저자들은 상악동에 발생한 반전성 유두종 2예에 대해 변형 경비강 내시경하 상악골 내측절제술로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다. Two Cases of the Inverted Papilloma in the Maxillary Sinus Treated by Modified Transnasal Endoscopic Medial Maxillectomy

Squamous papilloma of the hard palate

Oral squamous papillomas are benign proliferating lesions induced by human papilloma virus. These lesions are painless and slowly growing masses. As an oral lesion, it raises concern because of its clinical appearance. These lesions commonly occur between age 30 and 50 years, and sometimes can occur before the age of 10 years. Oral squamous papilloma accounts for 8% of all oral tumors in children. Common site predilection for the lesion is the tongue and soft palate, and may occur on any other surface of the oral cavity such as the uvula and vermilion of the lip. Here, we are presenting a case of squamous papilloma on the palate.

高齢者の口蓋垂に生じた扁平上皮乳頭腫の1例

高齢者の口蓋垂に生じた扁平上皮乳頭腫の1例

Glottic Papilloma in Pregnancy

ABSTRACT Respiratory papilloma (RP) is the most common benign neoplasm of the larynx, both in children and in adult. The etiology of recurrent respiratory papilloma is human papilloma virus (HPV), which has propensity to lay in normal epithelium, hence the high rate of recurrence. We report a case of an adult onset large glottic papilloma seen in a female with 3rd trimester pregnancy, which was excised under microscope under local anesthesia. The effect of pregnancy and latest modalities of treatment are discussed in this article. How to cite this article Mittal R, Verma H, Mathur N, Bhuie HS. Glottic Papilloma in Pregnancy. Int J Phonosurg Laryngol 2014;4(1):43-44.

Gastric squamous papilloma in a 52-year-old female patient.

A papilloma is a benign epithelial lesion characterized by finger-like projections of tissue lined by an overgrowth of squamous cells and a core of connective tissue. We report a case of squamous papilloma on the cardia in a 52-year-old asymptomatic female. Endoscopy showed a 1-cm sized is polyp with hyperemic change originating from the cardia adjacent to the esophagogastric junction, the biopsy of which suggested a diagnosis of squamous papilloma. Endoscopic mucosal resection was performed to obtain a definite diagnosis and the polyp was completely removed. The histological result was compatible with squamous papilloma, and its surrounding tissues showed foveolar epithelium, which suggested a stomach origin. This is the first report of endoscopic resection of a gastric squamous papilloma. Squamous papilloma should be considered in the differential diagnosis of a gastric polyp, especially one in the cardia. As the prognostic value of a squamous papilloma is not well known, we recommend endoscopic resection to treat a gastric squamous papilloma, when possible.

多数の核内細胞質封入体と核溝を有し悪性が疑われた乳腺硬化性乳頭腫 (乳管腺腫) の 1 例

背景 : 核内細胞質封入体と核溝は甲状腺乳頭癌の重要な細胞所見とされている. 今回われわれは, 乳腺穿刺吸引細胞診で核内細胞質封入体と核溝を有し, 甲状腺乳頭癌の乳腺転移や悪性乳腺腫瘍との鑑別が困難であった乳腺硬化性乳頭腫 (乳管腺腫) の 1 例を経験したので報告する.症例 : 60 歳, 女性. 右乳房腫瘤を自覚し近医受診. 精査加療目的で当院紹介され, 右乳癌 (浸潤性小葉癌) と診断された. 画像検査で, 左乳房の B と D 領域にも小腫瘤を指摘され, この 2 個の腫瘤に対して穿刺吸引細胞診が施行された. 細胞像より甲状腺乳頭癌の転移の可能性も含めて悪性が考えられ, 生検がすすめられた. 針生検と摘出生検では硬化性乳頭腫 (乳管腺腫) と診断された.結論 : 過去の報告より, 乳腺穿刺吸引細胞診において核内細胞質封入体がみられる場合は, 良性の可能性が高く, その他の所見も十分加味して組織型を推定する必要があると考えられた.

マンモグラフィにて特異な石灰化を認めた若年者の乳管内乳頭腫の１例

症例は26歳，女性。1年前から右乳腺CDエリアに腫瘤を自覚していた。右乳頭から白色調の分泌液を自覚したため当院来院。乳頭分泌液細胞診は陰性であった。マンモグラフィでは，右CDの拡張した乳管内に集簇性の淡く不明瞭な石灰化を認め，分枝状の形を呈した。乳腺エコーで，右CDに拡張した乳管とその内部に乳頭状に増殖した腫瘤を認めた。乳腺造影MRIでは，腫瘤は早期より造影され，次第に漸増するパターンを示した。以上より，乳管内乳頭腫(intraductal papilloma, IP)と診断し，乳管腺葉区域切除術を行った。切除標本では，IPの一部に腺の増殖と間質の硬化，多数の微小石灰化を認めた。石灰化は，増殖した腺腔内の分泌物に由来するものと考えられた。本症例では，マンモグラフィの特異な石灰化の原因は，硬化性乳頭腫の一部で上皮が脱落・消失した結果，乳管小葉構造を反映する分枝状の石灰化のみが間質に残り，石灰化が互いに癒合したことと考えられた。IPでは，稀に血行障害による梗塞などの原因で今回のような上皮脱落を伴う間質の硬化を来し，特異な石灰化を呈することも念頭に入れる必要があると考えられた。

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.