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Mayo Clinic Proceedings Apr 2021
Topics: Adult; Biopsy; Breast Neoplasms; Female; Humans; Papilloma; Practice Guidelines as Topic; Young Adult
PubMed: 33814084
DOI: 10.1016/j.mayocp.2021.02.018 -
Oral Papillomatosis: Its Relation with Human Papilloma Virus Infection and Local Immunity-An Update.Medicina (Kaunas, Lithuania) Aug 2022Oral papilloma lesions may appear as a result of HPV infection, or not, and only special molecular methods could differentiate them. Low-risk and high-risk HPV types... (Review)
Review
Oral papilloma lesions may appear as a result of HPV infection, or not, and only special molecular methods could differentiate them. Low-risk and high-risk HPV types could induce oral HPV papillomatosis with different natural evolution, clearance and persistence mechanisms. The pathogenic mechanisms are based on the crosstalk between the oral epithelial and immune cells and this very efficient virus. HPV acts as a direct inducer in the process of transforming a benign lesion into a malignant one, the cancerization process being also debated in this paper. According to the degree of malignity, three types of papillomatous lesions can be described in the oral cavity: benign lesions, potential malign disorders and malignant lesions. The precise molecular diagnostic is important to identify the presence of various virus types and also the virus products responsible for its oncogenicity. An accurate diagnostic of oral papilloma can be established through a good knowledge of etiological and epidemiological factors, clinical examination and laboratory tests. This review intends to update the pathogenic mechanisms driving the macroscopic and histological features of oral papillomatosis having HPV infection as the main etiological factor, focusing on its interreference in the local immunity. In the absence of an accurate molecular diagnostic and knowledge of local immunological conditions, the therapeutic strategy could be difficult to decide.
Topics: Humans; Mouth Neoplasms; Papilloma; Papillomaviridae; Papillomavirus Infections
PubMed: 36013570
DOI: 10.3390/medicina58081103 -
Wiener Klinische Wochenschrift Jun 2016
Topics: Adult; Esophageal Neoplasms; Esophagoscopy; Female; Humans; Papilloma
PubMed: 27271553
DOI: 10.1007/s00508-016-1003-z -
JAMA Otolaryngology-- Head & Neck... Nov 2017The risk factors for the recurrence of sinonasal inverted papilloma are still unclear. (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
The risk factors for the recurrence of sinonasal inverted papilloma are still unclear.
OBJECTIVE
To investigate the potential association between the Krouse classification and the recurrence rates of sinonasal inverted papilloma.
DATA SOURCES
The EMBASE and MEDLINE databases were searched for the period January 1, 1964, through September 30, 2016, using the following search strategy: (paranasal sinuses [Medical Subject Headings (MeSH) terms] OR sinonasal [all fields]) AND (inverted papilloma [MeSH terms] OR (inverted [all fields] AND papilloma [all fields]).
STUDY SELECTION
The inclusion criteria were (1) studies including sinonasal inverted papilloma only and no other forms of papillomas, such as oncocytic papilloma; (2) minimum follow-up of 1 year after the surgery; and (3) clear report of cases (recurrence) and controls according to the Krouse classification system or deducible from the full-text article. Literature search was performed by 2 reviewers. Of the 625 articles retrieved in the literature, 97 full-text articles were reviewed. Observational cohort studies or randomized controlled trials were included, and the following variables were extracted from full-text articles: authors of the study, publication year, follow-up data, and number of cases (recurrence) and controls (no recurrence) in each of the 4 stages of the Krouse classification system.
DATA EXTRACTION AND SYNTHESIS
The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Odds ratios (ORs) and 95% CIs were estimated, and data of included studies were pooled using a random-effects model.
MAIN OUTCOMES AND MEASURES
The main outcome was recurrence after surgical removal of sinonasal inverted papilloma according to each stage of the Krouse classification system.
RESULTS
Thirteen studies comprising 1787 patients were analyzed. A significant increased risk of recurrence (51%) was highlighted for Krouse stage T3 disease when compared with stage T2 (pooled OR, 1.51; 95% CI, 1.09-2.09). No significant difference in risk of recurrence was found between Krouse stages T1 and T2 disease (pooled OR, 1.14; 95% CI, 0.63-2.04) or between stages T3 and T4 (pooled OR, 1.27; 95% CI, 0.72-2.26).
CONCLUSIONS AND RELEVANCE
Inverted papillomas classified as stage T3 according to the Krouse classification system presented a 51% higher likelihood of recurrence. Head and neck surgeons must be aware of this higher likelihood of recurrence when planning and performing surgery for sinonasal inverted papilloma.
Topics: Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Papilloma, Inverted; Paranasal Sinus Neoplasms; Patient Care Planning
PubMed: 28973390
DOI: 10.1001/jamaoto.2017.1686 -
Cutis May 2019
Topics: Adult; Diagnosis, Differential; Dyspareunia; Female; Humans; Papilloma; Vulvar Neoplasms
PubMed: 31233593
DOI: No ID Found -
Archives of Pathology & Laboratory... Nov 2019Sinonasal papillomas and carcinomas are uncommon head and neck neoplasms that comprise a broad clinicopathologic and morphologic spectrum, and thus frequently represent... (Review)
Review
CONTEXT.—
Sinonasal papillomas and carcinomas are uncommon head and neck neoplasms that comprise a broad clinicopathologic and morphologic spectrum, and thus frequently represent a diagnostic challenge for surgical pathologists. Recent molecular interrogation of these tumors has delineated a number of recurrent alterations that correspond to distinct entities with potential diagnostic and/or therapeutic clinical utility.
OBJECTIVE.—
To summarize the salient clinicopathologic, morphologic, and molecular features of sinonasal papillomas and carcinomas.
DATA SOURCES.—
Review of pertinent literature regarding sinonasal papillomas and sinonasal carcinomas.
CONCLUSIONS.—
Despite their relative rarity in many surgical pathology practices, sinonasal papillomas and carcinomas frequently demonstrate characteristic morphologic features that are important for accurate diagnosis. Given our emerging understanding of the molecular basis for these tumors, judicious use of available ancillary tools-including immunohistochemistry and in situ hybridization-may be helpful in subsets of cases, whereas additional molecular testing may be useful for diagnostically challenging and/or clinically aggressive sinonasal tumors.
Topics: Carcinoma; Humans; Immunohistochemistry; In Situ Hybridization; Papilloma; Paranasal Sinus Neoplasms
PubMed: 31661314
DOI: 10.5858/arpa.2019-0372-RA -
Ophthalmology Nov 2015
Topics: Biopsy; Child; Eyelid Neoplasms; Humans; Male; Melanocytes; Neoplasms, Multiple Primary; Nevus, Pigmented; Papilloma; Skin Neoplasms
PubMed: 26498077
DOI: 10.1016/j.ophtha.2015.08.040 -
Otology & Neurotology : Official... Oct 2023Papillomas originating from the Schneiderian epithelium within the middle ear are extremely rare and may be associated with a high rate of recurrence and malignant...
OBJECTIVE
Papillomas originating from the Schneiderian epithelium within the middle ear are extremely rare and may be associated with a high rate of recurrence and malignant transformation. Oncocytic papillomas represent the rarest pathological subtype of such tumors. The current investigation aimed to determine whether there exists a distinct mechanism underlying the incidence of oncocytic papillomas arising primarily within the middle ear, and to explore potential treatment strategies to ensure complete removal and prevent recurrence.
STUDY DESIGN
Search of the English literature for cases of middle ear papilloma and RNA sequencing analysis of three samples from one new case presenting at the Eye and ENT Hospital, Fudan University (Shanghai, China), with recurrent middle ear oncocytic papilloma, along with two normal mucosal samples.
SETTING
Academic, tertiary referral hospital.
PATIENT AND INTERVENTIONS
The patient underwent open mastoidectomy and endoscopic tympanoplasty twice in 6 years. Histopathology confirmed oncocytic papilloma in middle ear. The patient has been free of the disease at 18 months of follow-up without radiation, whereas the RNA-seq analysis of the samples in endoscopic operations remained nonmalignant.
RESULTS
Only four cases of primary middle ear oncocytic papillomas have been reported. Recurrent masses usually originate from around the eustachian tube, which may explain the pathogenesis of this lesion. RNA-seq analysis was used to identify 1,317 (UP, 239; DOWN, 1078) differentially expressed genes between papillomas and normal mucosa. The involvement of some hub proteins (e.g., FN1, CXCL8, L10, JUN, and FOS) in the pathogenesis of primary middle ear papillomas was found to align with the observed clinical features.
CONCLUSION
The middle ear oncocytic papillomas were extremely rare and remained incompletely understood. The findings of this first RNA-seq analysis of this rare tumor may serve to enhance comprehension of and aid in the management of middle ear papillomas.
Topics: Humans; China; Ear, Middle; Papilloma; Endoscopy; Eustachian Tube
PubMed: 37604509
DOI: 10.1097/MAO.0000000000003993 -
The Breast Journal Apr 2020In many centers internationally, current standard of care is to excise all papillomas of the breast, despite recently reported low rates of upgrade to malignancy on...
In many centers internationally, current standard of care is to excise all papillomas of the breast, despite recently reported low rates of upgrade to malignancy on final excision. The objective of this study was to determine the upgrade rate to malignancy in patients with papilloma without atypia. A retrospective review of a prospectively maintained database of all cases of benign intraductal papilloma in a tertiary referral symptomatic breast unit between July 2008 and July 2018 was performed. Patients with evidence of malignancy or atypia on core biopsy and those with a history of breast cancer or genetic mutations predisposing to breast cancer were excluded. One hundred and seventy-three cases of benign papilloma diagnosed on core biopsy were identified. Following exclusions, the final cohort comprised of 138 patients. Mean age at presentation was 51. Mean follow-up time was 9.6 months. The most common symptom was a lump (40%). Of the 124 patients who underwent excision, three had ductal carcinoma in situ and there were no cases of invasive disease, giving an upgrade rate to malignancy of 2.4%. Upgrade to other high-risk lesions (atypical lobular and ductal hyperplasia and lobular carcinoma in situ) was demonstrated in 15 cases (12.1%). Benign papilloma was confirmed in 100 cases (81.5%), and 6 (4.8%) had no residual papilloma found on final excision. Twelve patients (8.7%) were managed conservatively. Of those, one later went on to develop malignancy. Patients with a diagnosis of benign papilloma without atypia on core biopsy have a low risk of upgrade to malignancy on final pathology, suggesting that observation may be a safe alternative to surgical excision. Further research is warranted to determine which patients can be safely managed conservatively.
Topics: Biopsy, Large-Core Needle; Breast; Breast Neoplasms; Female; Humans; Papilloma; Papilloma, Intraductal; Retrospective Studies
PubMed: 31612568
DOI: 10.1111/tbj.13642 -
Ear, Nose, & Throat Journal Aug 2021Incidental papillomas of the pharynx can be found while examining the nasopharynx, oropharynx, and hypopharynx for other disorders of the head and neck. Purpose of the...
INTRODUCTION
Incidental papillomas of the pharynx can be found while examining the nasopharynx, oropharynx, and hypopharynx for other disorders of the head and neck. Purpose of the study is to explore the location, biopsy protocol, and decision to perform office-based versus operative management via potassium titanyl phosphate (KTP) laser when an oropharyngeal papilloma is discovered incidentally.
METHODS
A retrospective review of the senior author's patient population was performed using Current Procedural Terminology and/or codes to identify patients who had KTP laser removal of incidental oropharyngeal papillomas. Patients were included based on the incidental nature of the papilloma and confirmed pathology report of squamous papilloma. Demographics, presenting complaint, lesion location, pathological analysis, type of intervention, and outcomes were recorded. When available, human papillomavirus (HPV) subtype was noted.
RESULTS
A total of 26 cases were identified, 13 females and 13 males. The median age at time of surgery was 58 years (range: 21-77). The most common presenting symptoms were difficulty swallowing and throat pain. The most common locations were the base of tongue, uvula, tonsils, and the soft palate. Of the 26 patients, 23 patients received KTP laser ablation therapy as an office-based procedure, while the remaining 3 were performed under general anesthesia in the operating room. Only 5 patients had a recorded recurrence that required reoperation. There were no operative or postoperative complications. There were 16 biopsy samples tested for HPV, where 12 were negative for HPV and 4 were positive for HPV.
CONCLUSION
Oropharyngeal papillomas, when present, can be found incidentally during examination of the oropharynx for other symptoms. Office-based biopsy and KTP laser is a safe and efficient means of identifying and removing most oropharyngeal papillomas.
Topics: Adult; Aged; Ambulatory Surgical Procedures; Biopsy; Clinical Decision-Making; Deglutition Disorders; Female; Humans; Incidental Findings; Lasers, Solid-State; Male; Middle Aged; Oropharyngeal Neoplasms; Oropharynx; Papilloma; Retrospective Studies; Young Adult
PubMed: 31581834
DOI: 10.1177/0145561319871228