Oral Papilloma

Aka: Oral Papilloma, Oral Squamous Papilloma, Oral Papillomatosis

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II. Pathophysiology

  1. Human Papillomavirus (most commonly HPV 6, 11) affecting squamous epithelium on the Oral Mucosa, lip or Tongue
  2. Similar to Genital Human Papillomavirus

III. Epidemiology

  1. Onset age 30 to 50 years

IV. Signs

  1. Single, exophytic tumors most commonly on the Oral Mucosa or ventral Tongue
    1. May also be found on lips and Palate
  2. Lesions are typically smaller (<1 cm), and not clustered (unlike Condyloma acuminatum)
  3. Numerous finger-like projections from a rough surface (verrucous lesions with cauliflower appearance)

V. Differential Diagnosis

  1. See Tongue Mass
  2. See Oral Lesion
  3. Condyloma acuminatum
    1. Although also caused by HPV 6 and 11, associated with higher cancer-risk types (HPV 16 or 18)
    2. Single or multiple dome shaped lesions, larger than papilloma
    3. Localized to the dorsal Tongue and lingual frenulum

VI. Labs

  1. Biopsy
    1. Exophytic fronds with fibrovascular cores
    2. Koilocytes
    3. Keratinization

VII. Management

  1. Surgical excision (preferred, lowest recurrence rate)
  2. Cryotherapy
  3. Laser ablation

VIII. References

  1. Straub (2024) Am Fam Physician 110(5): 467-75 [PubMed]
  2. Syrjänen (2018) Eur J Oral Sci 126 Suppl 1(Suppl Suppl 1):49-66 +PMID: 30178562 [PubMed]

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