Tuesday, March 11, 2014

Cauliflower Like Growth in Mouth !

 

Cauliflower like growth in the mouth is commonly due to papilloma. It's a benign neoplastic growth which is usually not fatal.


Papilloma definition-  Papilloma is a common benign neoplasm arising from epithelial tissue of oral cavity and is characterized by an exophytic growth of the stratified squamous epithelium.

These lesions  constitute about 2% of all oral neoplasms and it is believed by many investigators that they are caused by the human papilloma virus.


Clinical features

Age: mostly third, fourth and fifth decade of life

Sex: Both sexes are equally affected.

Site: Tongue lips, buccal mucosa, gingiva, hard and soft palate.


Signs and symptoms: Clinical presentation

  • ‘Cauliflower like’growth which is slow growing exophytic and small, it is usually painless unless traumatized. 
  • It has several small finger-like projections on the surface.
  • Size is from millimeter to few centimeter in diameter.
  • The base is either pedunculated or broad based (sessile) but always well-circumscribed lesion.
  • Sometimes it may appear as ovoid swelling with the corrugated surface.
  • The surface of the papilloma is white because of the highly keratinized epithelium.
  • A non-keratinized lesion appears pinkish or grayish in color and it is softer in consistency.
  • Rarely an endophytic papilloma can be seen which grows inwardly.
  • Papillomatosis is a condition in which multiple papillomas are developed inside the mouth.


Histological feature


Proliferating stratified squamous epithelium in the form os multiple fingers like projections

Every single finger-like process has a vascular connective tissue core in cener which conatins few inflammatory cells.


Covered with squamous epithelium which shows hyperkeratosis. and acanthosis.

Although most of the papillary projections are long and finger like there can be small round and blunt projections.

Sometimes there may be a development of superficial ulcerations and secondary infection, because in the oral cavity these lesions are often subjected to trauma.


Differential diagnosis

  • Verruca Vulgaris
  • Focal dermal hyperplasia
  • Verruciform xanthoma
  • Verrucous carcinoma 
  • Fibro epithelial polyp.


Treatment

Surgical excision of the lesion including the base. Recurrence is rare.

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