Oral Squamous Cell Papilloma Research Articles

Management of mucogingival defect following excision of multiple gingival squamous cell papillomas using VISTA – A case report with 24 months follow-up

Abstract: Oral squamous cell papilloma is a benign proliferation of the stratified squamous epithelium, associated with the human papillomavirus (HPV). The clinical manifestation includes papillary or verrucous exophytic mass. Complete excision of the lesion, including normal margins, followed by histopathological examination is the treatment of choice. However, mucogingival defect may be observed after excision of the lesion, requiring management by perioplastic surgery. In this report, a 27-year-old male with an unremarkable medical history reported multiple sessile growths on his gingiva. The masses were located in the left maxillary canine and mandibular premolar regions, exhibiting finger-like projections with white and pink surface color. The lesions were removed by excisional biopsy and submitted for histopathologic examination. After excision, type II noncervical carious lesions (NCCLs) became exposed that were previously covered by papilloma outgrowths. Miller’s class I/RT1 recession defects that were present were managed by vestibular incision subperiosteal tunnel access (VISTA) in concert with amnion-chorion membrane (ACM) with 24 months’ follow-up. In this case report, mucogingival defects that resulted after the excision of multiple gingival squamous cell papillomas were managed by VISTA in concert with ACM. A favorable outcome was achieved that was stable during the 24-month follow-up.

Overview of common oral lesions.

This article summarises common oral lesions that clinicians may face in everyday practice by categorising them by clinical presentation: ulcerated lesions, white or mixed white-red lesions, lumps and bumps, and pigmented lesions. The pathologies covered include recurrent aphthous stomatitis, herpes simplex virus, oral squamous cell carcinoma, geographic tongue, oral candidosis, oral lichen planus, pre-malignant disorders, pyogenic granuloma, mucocele and squamous cell papilloma, oral melanoma, hairy tongue and amalgam tattoo. The objective of this review is to improve clinician knowledge and confidence in assessing and managing common oral lesions presenting in the primary care setting.

Recurrence rate of oral squamous cell papilloma after excision with surgical scalpel or laser therapy: A retrospective cohort study.

BackgroundThe aim was to describe the recurrence rates of Oral Squamous Cell Papilloma (OSCP) following surgical treatment with surgical scalpel and two different lasers (CO2 or Er,Cr;YSGG) and to determine the clinical and histopathologic features of these lesions.Material and MethodsA retrospective cohort study covering a period of 12 years (1997-2009) that included patients diagnosed of OSCP treated with surgical excision was performed. Data was processed using SPSS 22.0 (SPPS Inc. Chicago, USA) and a descriptive and bivariate analysis were conducted.ResultsA total of 37 histopathologically confirmed OSCP in 36 patients, 19 women (52.7%) and 17 men (47.2%) with an average age of 33.4 years (14-86 years) were included. Twenty-two cases were treated by excision with surgical scalpel excision, 11 with CO2 laser and 3 with Er,Cr:YSGG laser. The mean age was 35.4 years (14-86 years) and the distribution by gender was 19 women (52.7%) and 17 men (47.2%). The most common locations were the palate in 14 cases (37.8%), followed by the tongue in 11 cases (29.7%) and gingiva with 5 cases (13.5%). The average size of the lesions was 4.25 mm in diameter, with a mean evolution time of 5.9 months. The recurrence rate was slightly higher with the CO2 laser (14.3 %) in comparison with the conventional scalpel (10%). No recurrences for Er,Cr:YSGG were found.ConclusionsNo differences for recurrence rates for OSCP between groups were found. The recurrence rate is low, happening usually before 15 months of follow-up. OSCPs are lesions usually appearing in patients between 30 and 50 years of both genders and located predominantly on the palate, tongue and gingiva. Key words:Oral squamous cell papilloma, squamous cell papilloma, CO2 laser, recurrence.

Oral Squamous Cell Papilloma: A Case Report and Review

Oral Squamous Cell Papilloma: A Case Report and Review

Effect of Quadrivalent Human Papillomavirus Vaccination on Oral Squamous Cell Papillomas.

Cutaneous verruca vulgaris lesions (warts) and oral squamous cell papillomas are common lesions caused by human papillomavirus (HPV). Multiple reports have described cases of wart resolution following quadrivalent HPV vaccination. We report the case of a patient with chronic oral papillomas with resolution after quadrivalent HPV vaccination and perform a review of the literature. An immunocompetent man in his 60s presented with chronic verrucous papules on the lips, tongue, and buccal mucosa refractory to multiple excisions. Biopsy showed squamous cell papilloma, and DNA sequencing revealed HPV-32. He received the quadrivalent HPV vaccine resulting in clearance of all lesions after 3 months. We found 8 reported cases of disseminated, recurrent warts with resolution after quadrivalent HPV vaccination. Improvement was seen within 4 weeks of vaccination, and resolution after 3 to 8 months. We report the case of recurrent oral papillomas caused by HPV-32 with complete resolution after quadrivalent HPV vaccination and reviewed reports of resolution of recalcitrant and disseminated warts after vaccination. Production of cross-protective immunoglobulins and cytotoxic T cells is a possible mechanism. There remains a critical need for randomized clinical trials to assess efficacy of quadrivalent HPV vaccination for treatment of oral squamous papillomas and cutaneous verruca vulgaris.

ORAL SQUAMOUS CELL PAPILLOMA: A CASE REPORT

Oral squamous cell papilloma (OSCP) is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass. OSCP is usually associated with human papilloma virus. Although any surface of the oral cavity can be affected, the sites of predilection for localization of the lesions include the tongue, lip and soft palate. In this report, treatment and histological findings of a local gingival enlargement at the vestibular side of the upper right central tooth of a 10 year-old systemically healthy girl are presented. The lesion was asymptomatic and had shown a slow growth. Solitary, exophytic lesion was clinically soft, pink-white in color and appeared as cauliflower. Dental and periodontal tissues were radiographically normal. One month after scaling and root planing, under local anesthesia the lesion was excised and this was followed by the use of Nd: YAG laser (1064 nm, 20 Hz, 3 W) to control bleeding, minimize pain and scarring in post-operative period, and provide sterilization. Macroscopic examination revealed that the lesion was 1.1×0.5×0.2 cm3 in size, yellow in colour and had a rough surface, while histological examination showed multi-layer connective tissue underlying the squamous epithelium, numerous rete pegs and spinous cell proliferation at the papillary and OSCP was diagnosed. There was no evidence of viral cytopathic effect or malignancy of the lesion. No recurrence was observed during the 4-year follow-up period.

Molecular biology for hpv typing in focal epithelial hyperplasia

Parichehr Ghalayani and colleagues (Volume 31, Number 1, Pages:060-063) report three interesting cases of focal epithelial hyperplasia (FEH) diagnosed through clinical and microscopic analysis (1). We would like to emphasize that, although the age and ethnicity of the patient may support the clinical suspicion of FEH, the histopathological features of FEH might be similar to that of condyloma acuminatum and oral squamous cell papilloma (2).

Detection of human papilloma virus DNA sequences in oral squamous cell papillomas by the polymerase chain reaction

Nineteen clinically diagnosed, and histologically confirmed oral squamous cell papillomas were analyzed for the presence of human papilloma virus DNA sequence by the highly sensitive polymerase chain reaction technique, followed by dot blot hybridization of the polymerase chain reaction product with digoxigenin-labeled, type-specific oligonucleotide probes for human papilloma virus DNA types 6, 11, 16, and 18. Human papilloma virus DNA types 6 and 11 were identified in 68% of these oral lesions, which raises the possibility of an etiologic role for human papilloma virus in the pathogenesis of oral squamous cell papillomas.

In situ DNA hybridization analysis of oral papillomas, leukoplakias, and carcinomas for human papillomavirus

Twenty-one papillomas, 23 ordinary benign keratoses, 13 smokeless tobacco keratoses, 10 verrucous hyperplasia, 10 verrucous carcinomas, 17 squamous cell carcinomas, 3 epithelial dysplasias, and 6 lichen planus lesions were evaluated for human papillomavirus (HPV) types 6 11 , 16 18 , and 31/33/35, with biotinylated double-stranded DNA probes in in situ hybridization. Sixty-two percent ( 13 21 ) of oral squamous papillomas were positive for HPV DNA. HPV DNA types 6 and 11 demonstrated the strongest reactivity. Of the 13 cases, 10 also showed some reactivity with HPV- 16 18 and -31/33/35. None of the cases of keratoses, epithelial dysplasia, squamous cell carcinoma, verrucous hyperplasia, verrucous carcinoma, or lichen planus were positive for HPV DNA. This study confirms the consistent and frequent finding of HPV DNA in oral squamous cell papillomas and the inconsistency of being able to identify HPV DNA in keratotic, premalignant, or cancerous lesions of the oral mucous membranes.

Human papillomavirus (HPV) in oral squamous cell papillomas.

One hundred and forty oral squamous cell papillomas (SCPs) were subjected to immunocytochemical staining for papillomavirus antigen using the immunoperoxidase-PAP method 41% of the oral squamous papillomas showed positive intranuclear staining, 50% were negative and the remaining 9% showed both intranuclear and cytoplasmic staining. In view of these findings it is suggested that a review of the etiology of lesions diagnosed as oral SCPs should be considered.

Peroxidase-antiperoxidase evaluation of human oral squamous cell papillomas

In human beings, the viral origin of condylomatous lesions of the mouth and cervix, multiple papillomas, and verruca vulgaris of the larynx has been established. The viral origin of papillomatosis in rabbits and dogs has also been documented. The literature, however, shows no conclusive evidence of a viral origin of human oral squamous cell papillomas (SCP). The purpose of this study was to use the peroxidase-antiperoxidase (PAP) staining technique to determine whether human papillomavirus (HPV) antigens exist in serial step sections of human oral SCP. Fifty human oral SCPs were randomly selected from the department files, and tissue sections were subjected to an indirect immunoperoxidase-PAP technique. Evidence of HPV-Type I virus antigens was found in 2 of 50 papillomas studied (2 of 194 tissue sections). This suggests that all oral SCPs are not of viral antigen.

The clinical and histopathologic features of a series of 464 oral squamous cell papillomas

A clinical and histopathologic analysis of 464 oral squamous cell papillomas is presented. Data on age, sex, race, location, clinical appearance, duration, recurrence, and clinical diegnosis are reviewed. One hundred seventy-six of the 464 specimens were examined for hyperkeratosis, character and amount of inflammatory infiltrate, and evidence of cellular atypia. The trends seen in this study support claims made by previous authors regarding incidence and inflammatory involvement. The data support a slightly higher occurrence rate in males than in females and in white as opposed to black patients. Papillomas were most abundant on the palatal complex, dorsum and lateral tongue borders, and lower lips, respectively. Confusion of papilloma for fibroma in the clinical diagnosis was less common than expected. Recurrence rate and incidence of multiple papillomas were low. Histologic study revealed a tendency for hyperkeratotic lesions to arise from nonkeratinized oral sites. Cellular atypia was found, but it is still unclear whether these changes are preneoplastic or due to an increased growth rate.