Different types of conjunctival papilloma presenting in. Symptoms consist of redness mainly due to vasodilation of the peripheral small blood vessels, edema swelling of the conjunctiva, itching, and increased lacrimation production of tears. Aimto examine conjunctival papillomas for the presence of human papillomavirus hpv and koilocytosis. Conjunctival papilloma american academy of ophthalmology. To elucidate the putative role of human papillomavirus hpv infection in pterygium and conjunctival papilloma. Conjunctival papilloma is a benign growth arising from the stratified squamous epithelium of the conjunctiva. A, anterior segment photograph of the giant ocular surface papilloma at baseline showing a nonpigmented, fleshy, papillomatous conjunctival mass with a cauliflowerlike appearance, involving the forniceal and bulbar conjunctiva and the eyelid margins of the left eye. The etiology of conjunctival papillomas is not established, but human papillomavirus hpv infection is thought to be an important factor 2.
It can occur in both children and adults, typically with a slow progressive course. Papillomas have been associated with human papilloma virus hpv infection, usually types 6 and 11. Hpv type 611 is the most common hpv type in conjunctival papilloma. Human papilloma virus in neoplastic and nonneoplastic. Benign mostly conjunctival nevus representing nearly 70% of cases, conjunctival nevus cn is a benign mole that can. The incidence is highest among patients aged between 20 and 39 years. The study presents the largest material of conjunctival papilloma investigated for hpv and the first investigation of hpv in normal conjunctival tissue. Aim to examine conjunctival papillomas for the presence of human papillomavirus hpv and koilocytosis. But, by educating ourselves about these diseases and the various cases of misdiagnoses, we can prevent further misdiagnosis and provide these. Conjunctival papillomas are associated with human papillomavirus hpv infection.
Methods archival paraffin embedded tissue from 55 conjunctival papillomas was analysed for the presence of hpv by polymerase chain reaction and subsequent filter hybridisation. 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. Histological sections of the 55 papillomas were evaluated for the presence of koilocytosis. Topical interferon alpha2b can be utilized as an adjunctive therapy for recurring conjunctival papilloma. Ddx reactive papillary hyperplasia reactive papilloma beckwithcohen b et al. The purpose of the study was to evaluate the clinical features, treatment, and outcome of patients with conjunctival papilloma. Treatment consists of surgical excision with free margins, followed by. Squamous cell papillomas are typically associated with human papillomavirus hpv while for others the cause is unknown. The case of a five year old girl who was seen at the university of benin teaching hospital with severe, long standing. A 73yearold man presented to the clinic with a twoweek history of a progressively enlarging ocular surface lesion causing foreign body sensation. Primary tumors of the canine conjunctiva, eyelids and orbit.
To examine conjunctival papilloma and normal conjunctival tissue for the presence of human papillomavirus hpv. Update on diagnosis and management of conjunctival papilloma. A search of the database for the terms conjunctiva and papilloma revealed 145 samples classified as conjunctival squamous papillomas and 31 as conjunctival viral papillomas. Canine conjunctival reactive papilloma 358 cases in the coplow database 43 labrador retriever 43 golden retriever 28 cocker spaniel 20 shih tzu. Pdf to report the identification of human papillomavirus types in four. In children, the lesions are typically manifestations of an infection acquired during delivery. Cryotherapy of conjunctival papilloma jama ophthalmology. Human papillomavirus in conjunctival papilloma europe.
Neoplasia of the canine eyelids, conjunctiva and cornea philippe labelle, dvm, dacvp antech diagnostics. Shields, md, speaking on saturday at the cornea subspecialty day. Detection of human papillomavirus in pterygium and. 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. Ocular motility and slitlamp examination were otherwise unremarkable. Pdf update on diagnosis and management of conjunctival. Conjunctival papilloma is an acquired benign squamous cell tumor that can present at any age, but most frequently in the third and fourth decades of life. Aim to examine conjunctival papillomas for the presence of human papillomavirus hpv and. Human papillomavirus in normal conjunctival tissue and in conjunctival papilloma. Giant ocular surface squamous cell papilloma treated with. More recently, topical alpha2b interferons have shown to be successful in treating not only primary conjunctival papilloma but also conjunctival intraepithelial neoplasia.
Follow up examination one year later showed no recurrence. A white, male patient, born in 1916, and treated elsewhere for recurrent conjunctival papillomas since 1978, was first seen by us in july 1987, presenting with a large sessile recurrent conjunctival papilloma on the temporal limbus and bulbar conjunctiva from 6 to 12 oclock. Conjunctival papilloma removal by direct excision using topical anesthesia. Human papillomavirus in conjunctival papilloma british. Conjunctival papilloma is a benign tumor of the conjunctival mucosa. Hpv type 16 in conjunctival and junctional papilloma. Topical interferon has been successful in treating conjunctival papillomas in 2 patients. Although allergens differ among patients, the most common cause is hay fever. Submission sheets, including signalment and chief complaint, were available for all.
One patient with a conjunctival papilloma and one patient with a. Ocular details included laterality of conjunctival papilloma unilateral or bilateral, eye affected right or left, and number of tumors per eye. Topical interferon in recurrent conjunctival papilloma. Methodsarchival parayn embedded tissue from 55 conjunctival papillomas. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. This tumor is usually easily identified by clinical examination since the conjunctiva is a readily visible structure, although tarsal. Conjunctival papilloma is an acquired benign squamous cell tumor that can present at any age, but. By carol shields, md t this article focuses on the most common types of benign and malignant conjunctival tumors. To report the effect of topical alphainterferon alphaif in two cases of recurrent conjunctival papillomas. Methodsarchival paraffin embedded tissue from 55 conjunctival papillomas was analysed for the presence of hpv by polymerase chain reaction and subsequent filter hybridisation. 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. Conjunctival papilloma is a benign acquired papillary lesion. Courtesy comparative ophthalmology section, the university of wisconsinmadison.
Mitomycinc is an adjunct therapy to surgical excision. A severe case of conjunctival papilloma in a five year old. Specimens of conjunctival papilloma registered during the period 19831997 were collected. Conjunctival papilloma is a benign epithelial tumor occurring in both children and adults with varying clinical features and outcomes. The coplow archives approximately 30 000 formalinfixed, paraffinembedded canine ocular tissues of various animals. Tumors of the conjunctiva 1192 of 6110 total neoplasms, 20%.
A fiveyearold boy with a twoyear history of conjunctival papilloma. Conjunctival papilloma is an acquired benign tumor that arises from the stratified squamous epithelium of the conjunctiva. In this article, we describe our experience regarding the difference in the clinical features and outcomes of conjunctival papilloma based on. Neoplasia of the canine eyelids, conjunctiva and cornea. For each case the patients sex and age, number of papillomaspatient, seasonal debut, duration, number of recurrences, localisation and presence of dysplasia andor inflammation in the papilloma were. A pigmented conjunctival squamous papilloma with a tortuous feeder vessel at the 9oclock position. Treatments for recurrent conjunctival papillomatosis rcp include surgical excision. Although histopathological diagnosis remains the gold standard, the advent of newer noninvasive imaging modalities such as optical coherence. Conjunctival papilloma caused by human papillomavirus type. The human papillomavirus hpv currently affects 79 million americans, and an additional 14 million new infections occur each year, said carol l.
Human papillomavirus in conjunctival papilloma british journal of. Inverted papilloma of the conjunctiva bmj open ophthalmology. Allergic conjunctivitis is inflammation of the conjunctiva the membrane covering the white part of the eye due to allergy. Unfortunately, several ocular diseases can masquerade as other diagnoses. 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. If you come across a malignancy, please contact a specialist about the best course of action for your patient. Primary tumors of the canine conjunctiva, eyelids and orbit richard r dubielzig. Conjunctival papilloma is a benign and common lesion. Specimens considered hpv positive using consensus primers, but with a. Human papillomavirus hpv6 and hpv11 are the major hpv types responsible for conjunctival lesions. It is hard to identify the free margin and depth of conjunctiva papilloma during excision surgery because of conjunctival bleeding and lack of microscopic. Selected references these references are in pubmed. In children, often near caruncle and semilunar fold, often bilateral or multiple, recurs after excision in adults, often near limbus, usually solitary, may grow over cornea.
Aim human papilloma virus hpv types 16 and 18 have been associated with neoplastic conditions of the conjunctiva. 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. In childhood, papilloma represents 710% of conjunctival tumors. Although histopathological diagnosis remains the gold standard, the advent of newer noninvasive imaging modalities such as optical. Longterm administration of topical interferon alfa2. Pdf purpose the purpose of the study was to evaluate the clinical features, treatment, and outcome of. However, the presence of this virus has not been reported in nonneoplastic disorders of the external eye nor has it been studied in normal conjunctival tissues. Pdf purpose the purpose of the study was to evaluate the clinical features, treatment, and outcome of patients with conjunctival papilloma. Morphological characteristics of conjunctival squamous. One patient with a conjunctival papilloma and one patient with a limbusbased. Conjunctival papillomas caused by human papillomavirus.
Human papillomavirus in normal conjunctival tissue and in. The full text of this article is available as a pdf 118k. The sensitivity of koilocytosis as an indicator of hpv in conjunctival papilloma is low. Human papillomavirus 6a lesions of the lower eyelid and genitalia. Pmc free article naghashfar z, mcdonnell pj, mcdonnell jm.
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. Unit of comparative ophthalmology, centre for small animal studies, po box 5, newmarket, suffolk cb8 7dw. Conjunctival papilloma is an acquired benign squamous cell tumor that. This may not be the complete list of references from this article. Pdf conjunctival papilloma and human papillomavirus. 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. To determine morphological and clinical characteristics of conjunctival papilloma.