Frequency of eyelid papillomas increases with age, usually more often seen after age 30. In adults, conjunctival papillomas are most likely venereal and are often associated with anogenital lesions. Conjunctival papilloma american academy of ophthalmology. Ocular motility and slitlamp examination were otherwise unremarkable. However, this association was not proved in the literature 5. Shields said, although most cases 90% affect adults. Conjunctival papilloma most commonly has an exophytic growth pattern. Papillomas are one of the most common benign eyelid lesions, and there is no race or sex predilection. The incidence is highest among patients aged between 20 and 39 years. Squamous cell papilloma of the conjunctiva due to human.
Infectious squamous conjunctival papillomas have a strong association with human papillomavirus hpv types 6 and 11 minchiotti et al. An incisional biopsy of the conjunctival papilloma like lesion was taken. Treatment consists of surgical excision with free margins, followed by cryotherapy. Squamous conjunctival papilloma squamous conjunctival papilloma note the atypical hyperpigmentation, fine vasculature and parse tumor stroma. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. In africa cases have been reported from south africa, kenya, tanzania, malawi, uganda, congo and ivory coast. Papillomas are tumors that grow from epithelial tissue and form outward fingerlike fronds. Unit of comparative ophthalmology, centre for small animal studies, po box 5, newmarket, suffolk cb8 7dw. These benign neoplasms are initiated after infection by the human papillomavirus hpv. Human papillomavirus in normal conjunctival tissue and in conjunctival papilloma. Morphological characteristics of conjunctival squamous. The second case was from a recurrent papilloma that had been excised twice previously. Archival paraffin waxembedded tissue from 165 conjunctival papillomas and from 20 histological normal conjunctival biopsy specimens was analysed for the presence of hpv by pcr. Hpv type 16 in conjunctival and junctional papilloma.
Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in kenya a case report by stephen gichuhi, timothy onyuma, ephantus macharia, joy kabiru, alain mbongo zindamoyen, mandeep s sagoo and matthew j burton. Squamous cell papilloma of the conjunctiva due to human papillomavirus hpv. Pdf different types of conjunctival papilloma presenting in the. Jun 14, 2019 mantyjarvi m, syrjanen s, kaipiainen s, et al. Long standing exophytic conjunctival papilloma infected with human.
Conjunctival papilloma can occur across the lifespan, dr. Conjunctival papilloma is a benign tumor of the conjunctival mucosa. A severe case of conjunctival papilloma in a five year old. Human papillomavirus in conjunctival papilloma british. A squamous cell papilloma is a generally benign papilloma that arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal.
Above describes two patients with the finding of multiple conjunctival papillomas of the eyelid margin. Dinitrochlorobenzene immunotherapy of recurrent squamous papilloma of the conjunctiva. Conjunctival papillomas are associated with human papillomavirus hpv infection. Inverted conjunctival papilloma, which is a dis tinct clinical entity, is a rare variant of the conjunc tival squamous papillomas and is also known as benign mucoepidermoid papilloma of the conjunc tiva.
There was a subepithelial, conjunctival, infiltrate of round and. Conjunctival papillomas caused by human papillomavirus type. Objective to determine the prevalence of a broad spectrum of human papillomavirus hpv types in conjunctival papillomas and a possible difference in clinical and histopathological presentation of hpvpositive and hpvnegative papillomas. A fiveyearold boy with a twoyear history of conjunctival papilloma caused. Epidemiological, clinical and computed tomographic profile of. Conjunctival papilloma caused by human papillomavirus type. Acute and chronic inflammatory cells are found within these fronds. Topical alphainterferon in recurrent conjunctival papilloma. Four cases of conjunctival inverted papillomas were retrieved from our files. Conjunctival papilloma is a benign and common tumour of the stratified squamous epithelium of the conjunctiva. The lacrimal sac and the conjunctiva are uncommon sites. Carbon dioxide laser therapy of recurrent squamous. Pdf conjunctival papilloma is an acquired benign squamous cell tumor that can present at any age, but most frequently in the third and fourth decades. However, any long standing conjunctival mass should not evade the surveillance of.
Conjunctival papilloma is an acquired benign tumor that arises from the stratified squamous epithelium of the conjunctiva. Only some of these types of lesions will progress to become tumours, and some will regress spontaneously, but it is advisable to cull such animals. Journal of pediatric ophthalmology and strabismus a 9yearold girl presented with an enlarged, elevated conjunctival lesion at the nasal limbus of her right eye. Nov 12, 2017 conjunctival papilloma can occur across the lifespan, dr. Squamous cell papillomas are typically associated with human papillomavirus hpv while for others the cause is unknown. Conjunctival papilloma is a benign acquired papillary lesion.
Specimens considered hpv positive using consensus primers, but with a negative or uncertain. Ocular rhinosporidiosis is a chronic granulomatous infection caused by a newly classified organism that is neither a fungus nor bacterium. Surgical excision with adjunctive therapy and longterm followup is rational for the treatment of conjunctival papilloma. Human papillomavirus in normal conjunctival tissue and in. Squamous cell papillomas eg, infectious papilloma, viral conjunctival papilloma are composed of multiple branching fronds emanating from a narrow pedunculated base. Conjunctival papilloma is a benign and common tumour of the strati. Conjunctival papilloma is a benign epithelial tumor with prominent intrinsic vascularity that displays characteristic hairpin vascular loops. Pdf a 31yearold black man presented with two oval masses in his right conjunctiva. A sessile conjunctival tumor involving the limbus was observed. Pdf purpose the purpose of the study was to evaluate the clinical features, treatment, and outcome of patients with conjunctival papilloma. It appears as an exophytic mass made of cauliflower appearance. View enhanced pdf access article on wiley online library html view download pdf for offline viewing.
There is a strong association of conjunctival papilloma with the human papillomavirus hpv, most notably strains 6 and 11 lowrisk and 16 and 33 highrisk. Conjunctival papillomas are categorized into infectious viral, squamous cell, limbal, and inverted histological description based on appearance, location, patients age, propensity to recur after excision, and histopathology. Inverted papillomatous epithelial lesion of the conjunctiva. A severe case of conjunctival papilloma in a five year old female oseluese anastasia dawodu and valentina okeigbemen department of ophthalmology, university of benin teaching hospital, benin city, nigeria abstract conjunctival papilloma is a benign growth arising from the stratified squamous epithelium of the conjunctiva. An infection with the human papilloma virus causes a pedunculated, wartlike lesion. A 73yearold man presented to the clinic with a twoweek history of a progressively enlarging ocular surface lesion causing foreign body sensation. The authors have been unable to find any details or descriptions of this type of papilloma in the. Carbon dioxide laser therapy of recurrent squamous papilloma. Sep 24, 2012 squamous cell papillomas of the conjunctiva are common benign lesions, and hpv is strongly associated with their occurrence. Ocular surface tumors ihab saad othman kasr elainie medical, school, cairo university, cairo, egypt tumors of the conjunctiva and cornea comprise a large and varied spectrum of conditions. Aug 06, 2016 conjunctival papilloma removal by direct excision using topical anesthesia. Topical interferon alpha 2 beta therapy in the management of conjunctival papilloma. These benign neoplasms are initiated after infection by. Pedunculated papillomas appear as clusters and are most often located in the fornix or palpebral.
Papillomavirus in human conjunctival papillomas sciencedirect. The code is valid for the year 2020 for the submission of hipaacovered transactions. Nodular squamous conjunctival carcinoma nodular squamous conjunctival carcinoma this squamous carcinoma exhibits a few corkscrew vessels on its surface arrow. Cases of conjunctival papilloma evaluated at a hospital that acts as a referral centre for native people indian and inuit from northern alberta and the northwest territories were compared with those from other hospitals in the same region whose referral base is primarily nonnative.
Clinical signs associated with inverted conjunctival papilloma are as follows. Conjunctival papilloma is a benign growth arising from the stratified squamous epithelium of the conjunctiva 1. Neoplasia of the canine eyelids, conjunctiva and cornea. Hpv is transmitted via direct human contact and typically produces benign tumor growths with minimal risk for malignancy. Figure 1 a inverted papilloma of the conjunctiva on the medial bulbar conjunctiva in a 77yearold woman, clinically mistaken for a nevus due to the pigmented appearance arrows.
Detection of human papillomavirus dna sequences in. Inverted papilloma of the conjunctiva bmj open ophthalmology. A 54 year old man was seen in kenya with a lesion that resembled a conjunctival papilloma. Conjunctival papillomas caused by human papillomavirus. Conjunctival rhabdomyosarcoma presenting as a squamous. A histopathological examination of the ocular lesion revealed acanthotic conjunctival epithelial growth in a fingerlike pattern with. The dogs ranged from six to nine years of age, four were female and one was male. Common conjunctival lesions drops usually clear the granuloma, but excision and cauterisation may be needed. They are known to occur in both children and adults but they are most common in the age group 2039 years. Conjunctival papillomas may have an exophytic, mixed or inverted. Detection of human papillomavirus type 11 dna in a conjunctival squamous cell papilloma by in situ hybridization with biotinylated probes. More males than females develop conjunctival papillomas and the incidence is highest among patients aged 2039 years.
Human papillomavirus hpv6 and hpv11 are the major hpv types responsible for conjunctival lesions. Multiple conjunctival papillomas of eyelid margins in. Sep 15, 2016 the conjunctival lesions may be gelatinous, papillary or, less commonly, leukoplakic, which occurs as a result of hyperkeratosis. This lesion is slow growing and is seen commonly in the nose, paranasal sinuses, or both. To examine conjunctival papilloma and normal conjunctival tissue for the presence of human papillomavirus hpv. In children, the lesions are typically manifestations of an infection acquired during delivery. The etiology of conjunctival papillomas is not established, but human papillomavirus hpv infection is thought to be an important factor 2. We report two unusual cases of pv patients presenting with multiple conjunctival papillomatous lesions of the eyelids margins. The duration of the symptoms ranged from 1 year to more than 20 years. Synonyms include squamous cell papilloma, conjunctival papilloma, infectious papilloma, and conjunctival wart.
Furthermore, the association between conjunctival papilloma and immunedeficiency and aids has been raised in the past. Ocular rhinosporidiosis mimicking conjunctival squamous. It often presents as a benign conjunctival tumour but may mimic other ocular conditions. Normally found in children or young adults, a common cause of conjunctival squamous cell papilloma is during childbirth, when the mother passes the virus to her child. We report resemblance to conjunctival papilloma and the result of vital staining with 0. Papillomas produce a permanent foreignbody sensation that is annoying to the patient, and the entire lesion should be surgically removed. Conjunctival papilloma is a benign and common lesion of the stratified squamous epithelium of the tarsal and bulbar conjunctiva 1. A conjunctival papilloma is a benign squamous epithelial tumor. The risk factors involved are hiv infection, prolonged exposure to ultraviolet radiation and hpv infection human papilloma virus.
Products purchased from 3rd party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. Figure 1 intra oral view of the lesion present on anterior part of hard palate figure 2 lesion seen on the finger figure 3 histopathological picture showing confirmation of squamous papilloma discussion. Conjunctival papillomas american academy of ophthalmology. Get a printable copy pdf file of the complete article. Exophytic growth of papillary, well differentiated, acanthotic nonkeratinized squamous epithelial cells with variable goblet cells supported by prominent, branching fibrovascular core. Individual fronds are surrounded by connective tissue, each having a central vascularized core. Conjunctiva and cornea philippe labelle, dvm, dacvp antech diagnostics. The most common location of conjunctival papilloma was the caruncle 43%, followed by palpebral conjunctiva 29%, bulbar conjunctiva 14%, and fornix 14%. T h e term papovavirus derives from the first two letters of the names of three of the viruses in the family, i. Ocular involvement in pemphigus vulgaris pv ranges from mild conjuctivits to conjunctival blisters and rarely prominent erosions of the bulbar and palpebral conjunctiva which may be found at the eyelid margin.
Different types of conjunctival papilloma presenting in. Histopathologic examination of the excised lesion revealed features of an inverted papilloma of the conjunctiva, which is an uncommon entity and has not been previously reported in. These lesions are usually well defined and will show some degree of feeder vasculature. Conjunctival papilloma removal by direct excision using topical anesthesia. They can grow in the skin, cervix, breast duct, or mucous membrane.
In evaluating patients, the clinician should ask about cutaneous warts, evaluate the patients immune status, and ask about family history of warts. Abstract five cases of unilateral bulbar conjunctival papillomata are reported in five different breeds of dog. Update on diagnosis and management of conjunctival papilloma. The conjunctival papilloma is primarily located medially and inferiorly. Methods formalinfixed, paraffinembedded papilloma tissue specimens obtained from 25 patients were analysed using six different pcrbased methods targeting. In childhood, papilloma represents 710% of conjunctival tumors. Pdf to text batch convert multiple files software please purchase personal license. Cancer eye in cattle department of primary industries. The lesion is unilateral and unifocal and does not recur after surgical excision. In all but one case the mass was an incidental finding. Cancer eye in cattle 2 nsw department of primary industries, october 2015 figure 2 a plaque on the edge of the eyeball. Most conjunctival papillomas occur in the plicacaruncle area 40%. Discussion we believe that our demonstration of papillomavirus structural antigen in two of 41 human conjunctival papillomas was the first immunologie evidence for the presence of this virus in this tumor. As in the skin, conjunctival papillomas can occur as branchingpediculate tumors or as broadbased lesions on the surface of the conjunctiva fig.
These tumors are grouped into two major categories of congenital and acquired lesions. A severe case of conjunctival papilloma in a five year old female. Update on diagnosis and management of conjunctival papilloma article pdf available in eye and vision 61 december 2019 with 125 reads how we measure reads. Conjunctival papillomas located in the inferior fornix are often pedunculated with a multilobulated appearance. Results a comparison of conjunctival papillomas between age groups revealed significant differences in the mean number of tumors per eye children and. Conjunctival lesions present commonly in primary care. The squamous cell papilloma of the conjunctiva is a benign and com mon epithelial tumour. Pacific university college of optometry eye on pacific. Conjunctival papillomas in norther canadian natives. Aimsto clarify the role of human papillomavirus hpv infection in the development of papilloma, dysplasia, squamous cell carcinoma, and basal cell epithelioma arising from the eyelids, including the tunica conjunctiva palpebrum conjunctiva, its junction to epidemis of eyelid skin junction, and eyelid skin. Our study confirms the link between conjunctival squamous cell carcinoma and hivaids.
Conjunctival papilloma the university of iowa, ophthalmology. Conjunctival papillomas are benign squamous epithelial tumors with minimal propensity toward malignancy. Review of the patient journals and pathology files revealed a range of age at diagnosis from 41 to 77 years, with an equal sex distribution. Conjunctival squamous cell carcinoma is a common malignant tumor in adults. Fulltext long standing exophytic conjunctival papilloma infected.
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