• Users Online: 111
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
Year : 2014  |  Volume : 5  |  Issue : 4  |  Page : 211-213

Squamous papilloma of the hard palate

1 Department of Pedodontics, Sharavathi Dental College, Shimoga, Karnataka, India
2 Department of Pedodontics, Vyas Dental College, Jodhpur, Rajasthan, India
3 Department of Conservative Dentistry and Endodontics, KLE Dental College, Belguam, Karnataka, India
4 BDS Student, KLE Dental College, Belguam, Karnataka, India

Date of Web Publication14-Nov-2014

Correspondence Address:
Prashant Babaji
Department of Pedodontics, Sharavathi Dental College, Shimoga, Karnataka
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-962X.144731

Rights and Permissions

Oral squamous papillomas are benign proliferating lesions induced by human papilloma virus. These lesions are painless and slowly growing masses. As an oral lesion, it raises concern because of its clinical appearance. These lesions commonly occur between age 30 and 50 years, and sometimes can occur before the age of 10 years. Oral squamous papilloma accounts for 8% of all oral tumors in children. Common site predilection for the lesion is the tongue and soft palate, and may occur on any other surface of the oral cavity such as the uvula and vermilion of the lip. Here, we are presenting a case of squamous papilloma on the palate.

Keywords: Cauliflower-like surface, HPV virus, oral lesion, palate, squamous papilloma

How to cite this article:
Babaji P, Singh V, Chaurasia VR, Masamatti VS, Sharma AM. Squamous papilloma of the hard palate . Indian J Dent 2014;5:211-3

How to cite this URL:
Babaji P, Singh V, Chaurasia VR, Masamatti VS, Sharma AM. Squamous papilloma of the hard palate . Indian J Dent [serial online] 2014 [cited 2020 Nov 25];5:211-3. Available from: https://www.ijdentistry.com/text.asp?2014/5/4/211/144731

  Introduction Top

Squamous papillomas are exophytic masses of the oral cavity, mostly benign and asymptomatic. They raise concern because of clinical appearance. Its pathogenesis is related to human papilloma virus (HPV) types 6 and 11. [1],[2],[3],[4] The occurrence of these lesions is influenced by smoking, co-existent infections, dietary deficiencies and hormonal changes. [5] Squamous papillomas are traditionally divided into two types: Isolated-solitary and multiple-recurring. The former is usually found in an adult's oral cavity, while the latter is mostly found in a child's laryngotracheobronchial complex. [6] The route of transmission of the HPV virus is unknown for oral lesions. These lesions commonly occur between the ages of 30 and 50 years, and sometimes can occur before the age of 10 years. Oral squamous papilloma accounts for 8% of all oral tumors in children. [1] The common site predilection for the lesion is the tongue and soft palate, and may occur on any other surface of the oral cavity such as the uvula and vermilion of the lip. [1],[2],[6] HPV involvement in head and neck carcinogenesis was first proposed by Syrjanen et al. in 1983. [1] Surgical removal is the treatment of choice by either routine excision or laser ablation. Other treatment modalities include electrocautery, cryosurgery and intralesional injections of interferon. Recurrence is uncommon, except for lesions in patients infected with human immunodeficiency virus (HIV). [6]

  Case report Top

A 14-year-old male patient was reported with a painless growth on the palatal surface of the mouth since 8 months. The patient noticed the growth around 8 months back, which started as a small growth, gradually increased in size over a period of 6 months and attained the present size of 3 × 3 cm. There was no history of pain, parasthesia or numbness associated with the growth and no similar lesions were present elsewhere. Family history was not significant. There was no positive medical or dental history. There was no habit of tobacco chewing, alcohol and drug use.

Intraoral examination revealed the presence of a solitary, well-defined, oval-shaped exophytic growth on the right half of the hard palate measuring 3 × 3 cm in size between the first and second molar regions on the palatal side [Figure 1]. The lesion had a cauliflower-like appearance. It was non-tender, firm in consistency and arose from the underlying soft tissue. The diagnostic hypothesis includes squamous cell carcinoma and verruca vulgaris. [2] The lesion was surgically excised without any post-operative complications [Figure 2]. The excised lesion [Figure 3] was sent for histopathological evaluation, which confirmed the squamous papilloma [Figure 4].
Figure 1: Squamous papilloma on the right side of the maxilla at the palatal surface

Click here to view
Figure 2: Excised squamous papilloma lesion

Click here to view
Figure 3: Post-excision area of the palate

Click here to view
Figure 4: Histopathological picture showing presence of finger-like projections and confirm squamous papilloma

Click here to view

  Discussion Top

Oral squamous papilloma is a generic term used for papillary and verrucous growths composed of benign epithelium and minor amounts of connective tissue. [6] Squamous cell carcinomas are the most common malignancies in adults, but are exceptionally rare in pediatric patients, particularly those involving the oral mucosa. Papillomas generally measure 1 cm in range and appear as pink to white exophytic granular or cauliflower-like appearance. They are generally asymptomatic. [6] Ribeiro et al. reported a case of oral squamous cell carcinoma that is uncommon. [7]

Squamous papillomas are classified into two types: Isolated-solitary and multiple-recurring. Isolated solitary is usually found in adults' oral cavity while multiple recurring occurs commonly in children. Isolated lesions are exophytic and pedunculated growths, resembling cauliflower appearance as seen in our case. [6]

Histologically, these lesions present as many long, thin and finger-like projections extending above the mucosal surface. Each finger-like projection is lined by stratified squamous epithelium and connective tissue centrally. The spinous cells proliferate in a papillary pattern. Koilocytes-HPV altered cells may be observed. The upper epithelial layer shows pyknotic nuclei, often surrounded by edematous or optically clear zone, the so-called "koilocytic" cell. [6]

The differential diagnosis of solitary oral squamous papilloma are verruciform xanthoma, papillary hyperplasia and condyloma acuminatum. Verruciform xanthoma has predilection for gingiva and alveolar ridge, while condyloma are larger than papilloma with broader base and appear pink to red. [6] Blood investigations such as enzyme-linked immunosorbent assay and the polymerase chain reaction test can be performed to detect the presence of virus. [2],[5]

Surgical removal of the lesion is the treatment of choice for oral squamous papilloms, either by surgical or electrocautery excision, cryosurgery, intralesional injections of interferon or laser ablation. The recurrence rate is very low for the solitary type compared with multiple lesions. [5],[6]

  Conclusion Top

Oral squamous papilloma is a benign proliferating lesions characterized by painless growth. Its pathogenesis is related the HPV. Early diagnosis and surgical excision should be performed to avoid further complications.

  References Top

Kumar BP, Khaitan T, Ramaswamy P, Pattipati S. Squamous papilloma. Int J Stomatol Occlusion Med 2013;6:106-9.  Back to cited text no. 1
Singh AP, Jain S, Chaitra TR, Kulkarni AU. Oral squamous papilloma: Report of a clinical rarity. BMJ Case Rep 2013.  Back to cited text no. 2
Major T, Szarka K, Sziklai I, Gergely L, Czegledy J. The characteristics of human papilloma virus DNA in head and neck cancers and papillomas. J Clin Pathol 2005;58:51-5.  Back to cited text no. 3
Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and mallofacial pathology. 3 rd ed. India. Guanabara Koogan ed, de Janeiro. 2010. 362-364 p.  Back to cited text no. 4
Carneiro TE, Marinho SA, Verli FD, Mesquita AT, Lima NL, Miranda JL. Oral squamous papilloma: Clinical, histologic and immunohistochemical analyses. J Oral Sci 2009;51:367-72.  Back to cited text no. 5
Jaju PP, Suvarna PV, Desai RS. Squamous papilloma: Case report and review of literature. Int J Oral Sci 2010;2:222-5.  Back to cited text no. 6
Ribeiro CM, Gueiros LA, Leon JE, do Carmo Abreu e Lima M, de Almeida OP, Leão JC. Oral squamous cell carcinoma in a 7-year-old Brazilian boy. Int J Oral Maxillofac Surg 2011;40:994-7.  Back to cited text no. 7


  [Figure 1], [Figure 2], [Figure 3], [Figure 4]

This article has been cited by
1 Sert Damakta Hpv ve Oral Kanser ile Iliskili Oral Skuamöz Papilloma: Bir Olgu Sunumu ve Literatür Derlemesi
Mine ÇETIN,Güldane MAGAT
[Pubmed] | [DOI]
2 A case report of squamous papilloma of the hard palate in a pediatric patient
AR Jaya,C Nagarathna,N Aishwarya
Journal of Indian Society of Pedodontics and Preventive Dentistry. 2020; 38(1): 91
[Pubmed] | [DOI]
3 Endoscopy-assisted resection of benign lesions on the base of the tongue via the transoral approach using a harmonic scalpel
Song Fan,Da-ming Zhang,Wei-liang Chen
Journal of Oral and Maxillofacial Surgery. 2017;
[Pubmed] | [DOI]
4 Partial glossectomy for treating extensive oral squamous cell papilloma
Emerson Filipe de Carvalho Nogueira,Pedro Henrique de Souza Lopes,Bruno Luiz Menezes de Souza,Cleice Barbosa Bezerra,Ricardo José de Holanda Vasconcellos,Belmino Carlos Amaral Torres
Brazilian Journal of Otorhinolaryngology. 2016;
[Pubmed] | [DOI]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Case report
Article Figures

 Article Access Statistics
    PDF Downloaded475    
    Comments [Add]    
    Cited by others 4    

Recommend this journal