Papilloma
Intraductal papilloma of breast, H&E, 10x
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 human papillomavirus (HPV), such as warts. Human papillomavirus infection is a major cause of cervical cancer, vulvar cancer, vaginal cancer, penis cancer, anal cancer, and HPV-positive oropharyngeal cancers.^{[2][3][4][5][6]} Most viral warts are caused by human papillomavirus infection (HPV),^[7] of which there are nearly 200 distinct human papillomaviruses (HPVs),^[4] and many HPV types are carcinogenic.^[2][3] There are, however, a number of other conditions that cause papilloma, as well as many cases in which there is no known cause.

Signs and symptoms

HPV6 pedunculated papilloma behind the uvula and HPV6 sessile 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 average size is between 1–5 cm. Neither sex is significantly more likely to develop them. The most common site is the palate-uvula area followed by tongue and lips. Durations range from weeks to 10 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.

Prognosis

There is no evidence that papillomas are premalignant.

Differential diagnosis

• Intraoral verruca vulgaris,
• Condyloma acuminatum, and
• Focal epithelial hyperplasia.

Note: differentiation is done accurately by microscopic examination only.

Treatment

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