Pathology
Oral Papillomatosis in Immunocompromised Patients: A Case Series of Kidney Transplant Recipients and Myelodysplastic Syndrome

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Solitary papilloma is a human papillomavirus (HPV)-induced benign indolent epithelial tumor with limited growth, whereas papillomatosis is an entirely different entity. Papillomatosis requires attention because of its aggressive and recurrent clinical progress with risks of dysplastic and malignant transformation. Recurrent respiratory papillomatosis (RRP) has a high prevalence of dysplasia and reports of transformation to carcinoma-ex-papillomatosis, especially when associated with low-risk HPV type 11. Although papillomatosis seldom occurs in the oral cavity, this report describes 3 cases of oral papillomatosis in immunocompromised patients, with 1 case identified as having HPV type 11. Two cases were kidney transplant recipients and the other case had a history of myelodysplastic syndrome followed by allogeneic bone marrow transplantation and graft-versus-host disease. Oral papillomatosis might be problematic, as in RRP, and periodic oral examination for persistent recurrences and malignant transformation can be beneficial to immunocompromised patients.

Section snippets

Case 1

A 51-year-old man visited the department of advanced general dentistry for discomfort caused by tooth extrusion. He had a medical history of 2 kidney transplantations 26 and 15 years previously, respectively. He had been taking tacrolimus and mycophenolate mofetil since then.

During oral examination, 3 pedunculated, clustered, whitish-pink papillary lesions (central, 15 × 6 × 5 mm; left, 12 × 4 × 4 mm; right, 6 × 6 × 5 mm) at the floor of the mouth and another separate pedunculated papillary

Discussion

Oral squamous papilloma is a benign papillary epithelial tumor believed to be associated with low-risk HPV 6 or 11 infection. Usually, it is a solitary lesion and has a maximum growth of 5 mm in diameter.18 Multiple growths of squamous papillomas are relevant to recurrent respiratory papillomatosis (RRP), which is frequently associated with HPV type 6 and 11 infections. RRP can involve any part of the aerodigestive tract but has a predilection for the larynx and has been discussed in relation

References (27)

  • L.C. da Silva et al.

    Oral lesions in renal transplant

    J Craniofac Surg

    (2012)
  • R.M. Lopez-Pintor et al.

    Comparison of oral lesion prevalence in renal transplant patients under immunosuppressive therapy and healthy controls

    Oral Dis

    (2010)
  • P. Ammatuna et al.

    Presence of Epstein-Barr virus, cytomegalovirus and human papillomavirus in normal oral mucosa of HIV-infected and renal transplant patients

    Oral Dis

    (2001)
  • Dr Kwak and Dr Choi contributed equally to this article.

    This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1C1B1012464).

    Conflict of Interest Disclosures: None of the authors have a relevant financial relationship(s) with a commercial interest.

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