Description: Papillomas appear as pedunculated or sessile, white or normal colored cauliflower-like projections that arise from the mucosal surface. In a study of 464 oral papillomas, it was learned that the average size is less than 1.0 cm, only 8% were larger than 2.0 cm. Many are only 3 or 4 millimeters. The same study revealed the mean age of patients with papilloma was 36.4 years with a range from 2 to 91 years. There was no strong sex preference. The most common site was the palateuvula area followed by tongue and lips. Of all sites, the soft palate was the most common and accounted for 20% of the lesions. The durations ranged from weeks to 10 years but 50% of the papillomas were present between 2 to 11 months.
Etiology: The etiology remains unknown. Viral origin has always been suspect but studies are still inconclusive. Immunoperoxidase techniques have identified antigens of the human papilloma virus (HPV) in a small number of cases. The same virus may be found in verruca vulgaris, condyloma acuminatum and focal epithelial hyperplasia all of which may resemble papillomas both clinically and microscopically.
Treatment: Conservative surgical excision, recurrence is rare.
Prognosis: Good, there is no evidence that papillomas are premalignant. Differential diagnosis: The rare intraoral verruca vulgaris and condyloma acuminatum resemble papillomas and microscopic examination may be required to distinguish between them. Large papillomas may resemble early verrucous carcinoma .