Presentation of Papilloma Cases Observed in Three Different Types: The Three Faces of Papilloma

Aim:

Oral squamous cell papilloma, the most frequently encountered benign epithelial tumor of the oral mucosa, is

etiologically associated with traumatic factors and HPV types 6 and 11 infections. In clinical practice, these lesions can

present in the oral cavity with highly diverse morphological types and appearances. The aim of this case report is to draw

attention to the broad spectrum of variations exhibited by oral squamous papilloma in clinical practice and to increase the

awareness of dentists regarding the differential diagnosis of these lesions.

Case Report:

In this case series, the clinical features (size, color, surface characteristics, and location) and differential diagnostic

approaches for the lesions of three different patients—who presented to our clinic for a routine dental examination and

were found to have oral lesions during intraoral evaluation—were assessed.

Case 1: During the intraoral examination of a 48-year-old male patient, a slightly elevated, broad-based, white,

asymptomatic lesion was observed in the soft palate region. Verruca vulgaris can be considered in the differential

diagnosis of the lesion. Like oral squamous papilloma, verruca vulgaris is HPV-induced; however, while verruca vulgaris

lesions are sessile (without a stalk), papillomas are pedunculated.

Case 2: During the intraoral examination of a 19-year-old male patient, an elevated, pedunculated, asymptomatic lesion

with a cauliflower-like appearance was observed in the lip region. A trauma-induced irritation fibroma, caused by the

orthodontic brackets on the maxillary anterior teeth, can be considered in the differential diagnosis of this lesion;

however, an irritation fibroma presents a more fibrotic appearance compared to an oral squamous papilloma.

Case 3:During the intraoral examination of a 71-year-old male patient, diffuse, multiple, asymptomatic lesions with a

papular appearance were observed on the floor of the mouth. Focal epithelial hyperplasia (Heck's disease) can be

considered in the differential diagnosis of this lesion. Focal epithelial hyperplasia is also multiple and sessile, but it has a

smoother surface.

The lesions were removed via excisional biopsy, and the diagnoses were confirmed by histopathological examination.

Conclusion:

Dentists play a key role in the early diagnosis of oral mucosal lesions. Although papillomas are benign, HPV awareness

and informing the patient about other systemic viral infections are importan

Keywords: Oral squamous cell papilloma, Human Papillomavirus / HPV , Differential diagnosi