Papillomas in the mouth
The content of the article:
- The reasons
- Classification
- Symptoms
- Diagnostics
- Treatment
- Alternative treatment
- Forecast
- Video
Papillomas in the mouth are benign true tumors originating from squamous stratified epithelium.
The disease is widespread. Affects people of any age. The incidence among women is 1.9 times higher than among men. In children, multiple neoplasms (papillomatosis of the oral cavity) prevail, and in adults - single ones.
In about half of patients, benign tumors are localized on the tongue.
Papillomas in the oral cavity can degenerate into cancer, especially if they are constantly injured
According to the histological structure, papillomas of the oral cavity are a tumor, which consists of cells of a squamous stratified highly differentiated epithelium with signs of keratinization. The polarity of the cells, their complexity and membrane integrity are preserved. In some areas, there may be signs of focal inflammatory infiltration.
The reasons
The cause of the appearance of papillomas (warts) on the mucous membrane of the oral cavity in 55-70% of cases is infection with human papillomavirus (HPV) type 6 or 11. Infection occurs through close contact with a sick person or a virus carrier.
The virus enters the cells of the basal layer of the epithelium and suppresses the activity of tumor suppressor genes. This, in turn, leads to dysregulation of the processes of cell proliferation (increase in the number of cells). For the development of the disease, it is enough to introduce single viral particles into the body. Reproduction of viral copies based on parental DNA occurs only in the basal layer of the stratified integumentary epithelium.
Since HPV has weak antigenic properties, the response production of endogenous interferon occurs in insufficient quantities. In addition, infection is accompanied by a decrease in cellular immunity. All this contributes to the long-term, often lifelong, retention of the virus in epithelial cells. Over time, infection leads to disruptions in the mechanism of cell differentiation.
The risk of the formation of multiple papillomas in the oral cavity increases with frequent trauma to the mucous membrane of the cheeks with poorly polished dentures, sharp edges of carious teeth. In children, epithelial neoplasms in the tongue can appear as a result of its chronic injury to the lower incisors due to a short frenum.
Classification
Depending on the number of neoplasms, single and multiple oral papillomas are distinguished.
According to the etiological factor, they are divided into several types:
| View | Description |
| Reactive (traumatic) | The growths are formed under the influence of temperature, chemical or mechanical stimuli. A characteristic feature of reactive papillomas is the termination of further growth of the formation after the removal of the stimulus. |
| Neoplastic (true) | Their occurrence is due to disturbances in the mechanism of differentiation, division and growth of epithelial cells. Most often they are localized on the inner side of the cheeks in the region of the retromolar zone near the pterygo-mandibular fold. |
| Viral | The human papillomavirus enters the epithelial cells through any damage to the mucous membrane. In the course of its life, it causes a violation of the processes of cell division and the formation of papillomas. |
Symptoms
Papillomatous formations in the mouth look like growths on the mucous membrane. There are many photos with a clear image of such neoplasms, which show that they have a rounded shape and a warty, folded or fine-grained surface, a thin or wide leg. The growths are surrounded by an unchanged mucous membrane of a pale pink color. The neoplasm usually does not cause discomfort in patients.
Papillomas have a soft-elastic consistency, painless on palpation. The mucous membrane covering them sometimes has a whitish tint, the appearance of which is associated with keratinization of the epithelium due to constant maceration with saliva.
The size of the tumor ranges from 0.1 to 2 cm. Neoplasms are single and multiple. Most often they are localized on the tongue, soft and hard palate. Somewhat less often, papillomas are observed on the gums, in the area of the bottom of the oral cavity. Also, places of localization of epithelial growths can be the throat, larynx.
For papillomas of the oral cavity, exophytic slow growth is characteristic. Opening the mouth is not difficult. Regional lymph nodes are not enlarged. The general condition of the patients is not affected.
When a neoplasm bites into its tissue, hemorrhage occurs, as a result of which it becomes dark in color and begins to bleed.
Diagnostics
Diagnosis of papillomas in the oral cavity does not cause difficulties and is based on patient complaints, data from a dental examination and anamnesis of the disease. To confirm the diagnosis, a histological examination of the neoplasm tissue is shown.
On examination, the dentist reveals the presence of pale pink or whitish rounded growths on the mucous membrane. There are no signs of an inflammatory process.
If a viral etiology of the disease is suspected, it is necessary to examine the patient for the presence of DNA of the human papillomavirus type 6 or 11, carried out by PCR diagnostics.
After removal of the neoplasm, the material must be sent for histological examination. If the tumor is benign, then it is characterized by:
- maintaining the integrity of membranes, stratification and cell polarity;
- poorly expressed cellular atypism;
- proliferation of cells of the spiny layer of the epithelium;
- the presence of signs of acanthosis in combination with hyperkeratosis;
- increased mitotic activity;
- hyperplasia of the basal layer;
- the growth of capillaries in the connective tissue.
The disease requires differential diagnosis with the following pathological processes:
- hyperplasia of the oral mucosa caused by a number of somatic diseases;
- iron Serra;
- fibroma.
Examination of a patient with papillomas in the mouth is carried out by a dentist. If you suspect a malignant transformation of the tumor, an oncologist's consultation is necessary.
Treatment
Treatment of single neoplasms is performed surgically. Neoplasms are excised within healthy tissues, after which the wound is sutured. Methods such as sclerotherapy, electrocautery and cryosurgery to remove papillomas are extremely rare, since they do not allow sampling material for histological examination.
In case of multiple forms of the disease, preference is given to a combined method of treatment. It consists in the fact that the doctor excises 1-2 neoplasms with a scalpel and transfers them for histological examination. The rest of the tumors are removed by electrocoagulation.
Only a specialist should remove papillomas in the oral cavity after the examination
If the formation of papillomas in the mouth is associated with infection of the patient with HPV, then in the postoperative period, the appointment of immunomodulating and antiviral drugs is indicated.
Alternative treatment
Traditional medicine recommends many different methods of treating warts in the oral cavity, but they either have insufficient effectiveness, or are associated with the risk of injury to the mucous membrane with subsequent infection. Let's consider some of them:
- Lubrication of the formation with cauterizing liquids (tincture of iodine, celandine juice, solutions of acids or alkalis). Such treatment often causes tumor malignancy, and can also cause deep burns.
- Reception of infusions or decoctions of poisonous plants (celandine, hemlock). The method is ineffective, since phytopreparations do not affect the cause of the disease (HPV infection). At the same time, ingestion of infusions of poisonous plants can cause serious poisoning, which can be fatal without timely provision of qualified medical care.
Any tumor, including such a seemingly harmless wart, is always fraught with the danger of degeneration into a malignant one. Therefore, you should not waste time trying to treat papillomas in the mouth on your own. When they appear, you should contact a specialist who will conduct the necessary examination and choose a removal method.
Forecast
True papillomas of the oral cavity are distinguished by high mitotic activity. In this regard, after surgical removal, there is a rather high risk of recurrence of the disease. In order to reduce it, the patient should definitely undergo a course of immunomodulatory and antiviral therapy.
If the cause of the neoplasm is associated with chronic trauma to the mucous membrane, then the elimination of the provoking factor excludes relapses.
Video
We offer for viewing a video on the topic of the article.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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