Oral squamous papilloma: report of a clinical rarity.

To cite: Singh AP, Jain S, Chaitra TR, et al. BMJ Case Reports Published online: 2 January 2013 doi:10.1136/ bcr-2012-007708 DESCRIPTION Oral squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass induced by human papilloma virus (HPV). 2 A 51-year-old, healthy steel plant male worker reported with complaint of growth on lower lip near the left corner of mouth since 2 years. His medical, dental and personal history was noncontributory. The left submandibular lymph nodes were palpable and tender. The lesion appears as a small, non-tender papule 2 years back and gradually increases up to its present appearance as exophytic, pedunculated, cauliflower-like appearance with white coloured finger-like projections of size 1×1 cm and asymptomatic (figure 1). Blood investigation ELISA and PCR tests were under the normal limits. Surgical excision was done and the biopsy specimen was sent for histopathological examination which revealed proliferation of the spinous layer cells, following a digitiform pattern with a delicate core of fibrous connective tissue constituting the supporting stroma suggestive of squamous papilloma (figure 2). A 1-year follow-up was performed, and there was no evidence of recurrence of the lesion. The association of HPV was considered as its pathogenesis especially HPV-6, 11, 16, which have already been identified in these lesions, but recent literature suggests that presence of HPV is an incidental finding and is unrelated to the development of a squamous papilloma. The presence of virus can be confirmed by PCR and by in situ hybridisation using radioisotopelabelled specific probes. However, hybridisation is less sensitive than PCR, which is considered the most suitable method for the detection of HPV.