Objectives
To examine the epidemiology, subtypes, trends over time, and predictive factors for recurrence and malignant transformation of sinonasal papillomas.
Methods
A retrospective chart review of ...118 patients with sinonasal papillomas from 2009 to 2019 was conducted at the University of California, Los Angeles. This study is a follow-up to a previously published study from 2000 to 2009 at the same academic center.
Results
The mean age was at presentation was 58.5 years, with a 2:1 male to female ratio, and average follow-up of 30.1 months. The rate of recurrence after complete resection was 19% with an average of 32.6 months to recurrence. The time to recurrence followed a bimodal distribution with 57% of cases recurring within 24 months (mean = 10) and 43% from 40 to 103 months (mean = 61). The proportion of the inverted papillomas rose from 38% in 2000-2004 to 89.6% in 2015-2019. Patients presenting at a younger age had a higher chance of recurrence (mean age 52 with recurrence vs. 61 without recurrence). Age did not correlate with histopathologic transformation in surgical pathology. Furthermore, histopathological transformation did not raise the chance of recurrence. Smoking, alcohol use, chronic rhinosinusitis, and allergic rhinitis were not associated with any of the outcome measures in this study. The most significant factor predicting recurrence, beside age at presentation, was the history of two or more prior sinus surgeries for papillomas or other reasons (OR = 3.52 and 5.81).
Conclusion
This study explored the features of sinonasal papillomas as well as the risk factors for recurrence and transformation. Younger age at presentation and two or more prior surgeries for papillomas were associated with recurrence. Time to recurrence followed a bimodal distribution, with late recurrences happenning from 40 to 103 months after surgery, emphasizing the importance of long-term follow-up for timely resection of tumors and prevention of malignancy.
Aims
Low‐grade papillary Schneiderian carcinoma (LGPSC) is a rare and newly described entity of the sinonasal tract. The aim of this study was to evaluate the clinicopathological and molecular ...characteristics in order to identify typical features for differential diagnosis.
Methods and results
Of the 3000 cases of sinonasal tumour studied during a period of 6 years, five cases were reviewed and diagnosed as LGPSC. All five patients were female (mean age, 47.8 years; range, 18–64 years) and had undergone multiple surgeries (3–10 surgeries). Both the sinonasal tract and the middle ear were involved in four patients. Nodal metastasis occurred in two patients, and one patient developed a distant metastasis to the left lung. Histologically, tumours had branched and crowded papillae with pushing boundaries. Tumour epithelia were multilayered and arranged in an orderly pattern without cilia. No malignant cytological features were observed in any of the cases. Immunohistochemical findings revealed a scattered distribution of Ki67‐positive cells and positive staining for epithelial membrane antigen, mainly in the outermost‐layer cells. Human papillomavirus (HPV) DNA was found in two patients and genotyped as HPV type 16. Sanger sequencing did not reveal any epidermal growth factor receptor or Kirsten rat sarcoma viral oncogene homologue gene mutation in the five cases.
Conclusions
We report on five new cases of LGPSC, and confirm LGPSC as a new sinonasal carcinoma that behaves aggressively with metastatic potential. The combination of clinical behaviour and typical histological features can distinguish LGPSC from sinonasal papilloma and other carcinomas.
Monitoring of condylomas is an early evidence of population effectiveness of human papillomavirus (HPV) vaccination programs. If reporting could include HPV typing, the contribution by vaccine HPV ...types to condyloma burden could be monitored.
A sentinel site for reporting of condyloma including HPV typing was established at the Centre for Sexual Health in Malmö, Sweden. In 2006 to 2009, when there were few HPV vaccines, 621 subjects with condyloma were reported and HPV genotyped.
Ninety-four percent of the condylomas contained genital HPV types. Thirty-five different genital HPV types were identified, with HPV6 (62%), HPV16 (13%), and HPV11 (10%) being the most common. At least 1 of the 4 HPV types in the HPV6/11/16/18 vaccine was detected in 77%. High-risk HPV types were more common in females (45%) than among males (27%) (odds ratio, 1.9; confidence interval, 1.3-2.8). Extended testing among subjects initially negative for HPV found 21 patients with cutaneous types of HPV, including a novel type (HPV153).
This report provides a baseline distribution of HPV types in condylomas before the introduction of an HPV vaccination program in this population. Human papillomavirus typing is feasible in routine condyloma reporting.
Objectives/Hypothesis
Aggressive laryngeal, tracheal, and pulmonary papilloma is an extremely challenging clinical problem without proven treatment options. A recent German report documented ...promising results with systemic bevacizumab. The objective of this study is to report the initial experience of this novel treatment in the United States for recurrent respiratory papillomatosis (RRP).
Study Design
Cases series.
Methods
Electronic survey of the RRP Task Force of the American Society of Pediatric Otolaryngology, American Broncho‐Esophagological Association, and physicians known to the authors to have used systemic bevacizumab for RRP.
Results
Eleven completed surveys were obtained. In three cases, systemic bevacizumab was considered clinically but not administered. Eight patients were treated with systemic bevacizumab, all for aggressive papillomatosis uncontrolled by surgical and adjuvant therapy, including seven of eight with pulmonary disease. Treatment dosing ranged from 5 to 10 mg/kg every 2 to 4 weeks, with all patients responding (7/8 partial response, 1/8 complete response). In four patients who had postbevacizumab chest imaging, three demonstrated improvement of disease and one stabilization. Treatment interval could be lengthened in seven patients and clinical response maintained. One patient with long‐standing pulmonary disease (>10 years) was diagnosed with malignant transformation while on treatment, and bevacizumab was discontinued in lieu of other chemotherapeutic agents. All other patients continue on systemic bevacizumab with minimal complications (hemoptysis n = 1, proteinuria n = 1).
Conclusions
Systemic bevacizumab appears to have significant promise in the most treatment‐resistant and aggressive forms of papillomatosis with a low complication profile. These results suggest bevacizumab should be studied in a formal clinical trial for RRP.
Level of Evidence
4. Laryngoscope, 127:2225–2229, 2017
Objectives
To assess malignant transformation rate, non‐sinonasal malignancies, and factors contributing to recurrence in patients treated for sinonasal inverted papilloma (SNIP).
Study Design
...Retrospective study.
Methods
We retrospectively reviewed medical records of all patients treated for SNIP (n = 296) between the years 1984–2014 at Helsinki University Hospital. Data from the Finnish Cancer Registry confirmed the number of those patients with sinonasal and non‐sinonasal malignancies.
Results
Only 2 of 296 (0.7%) patients primarily diagnosed with benign SNIP developed sinonasal cancer in a mean follow‐up of 5.8 years. The most common non‐sinonasal cancer sites were similar to those reported for the whole Finnish population. None of the patients presented with an HPV‐associated non‐sinonasal malignancy. The recurrence rate among patients who underwent attachment‐oriented surgery was significantly lower compared to those operated on with other approaches (40.2% vs. 56.6%, p = 0.006). Dysplasia in SNIP was associated with a higher recurrence rate (p < 0.001).
Conclusions
Malignant transformation of SNIP was rare. Patients with SNIP were not prone to HPV‐associated non‐sinonasal malignancies. Endoscopic resection and attachment‐oriented surgery have become predominant approaches in the treatment of SNIP; meanwhile, the total number of SNIP recurrences has decreased.
Level of Evidence
3 Laryngoscope, 133:506–511, 2023
Schneiderian papillomas are uncommon tumors which may develop within the nasal cavity and comprise three well-defined histological types: sinonasal inverted papilloma (SNIP), exophytic papilloma, and ...oncocytic papilloma. It is well known the rate of Schneiderian papilloma may also present a malignant degeneration and SNIP represents the most important subgroup in consideration of its frequency and malignant propensity. Although HPV infection is always considered the first event favoring the development of SNIP, however, it is not established as an eventual connection between viral actions and malignant transformation. In fact, different molecular mechanisms are suspected to play a crucial role in this process and, currently, many authors agree that only by improving our knowledge about these mechanisms it will be possible to achieve new and effective targeted therapies. So the aim of this study was firstly to systematically review the literature focusing on different biomarkers that could be implicated in the stages of SNIP malignant degeneration. Secondly, a systematic review with meta-analysis was performed to better define the incidence of sinonasal malignancies originating from Schneiderian papilloma (SNIP, exophytic papilloma, and oncocytic papilloma). Twenty-nine studies comprising a total of 3177 patients were statistically analyzed. Results showed a 9% (95% CI = 7–11) overall rate of malignant transformation from Schneiderian papilloma. In conclusion, this analysis confirmed that the potential malignancy of Schneiderian papilloma should not be underestimated. On the other hand, our review showed the paucity of studies investigating the molecular alterations which may be related with the malignant transformation of SNIP.
SARS‐CoV‐2 is assumed to use angiotensin‐converting enzyme 2 (ACE2) and other auxiliary proteins for cell entry. Recent studies have described conjunctival congestion in 0.8% of patients with ...laboratory‐confirmed severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), and there has been speculation that SARS‐CoV‐2 can be transmitted through the conjunctiva. However, it is currently unclear whether conjunctival epithelial cells express ACE2 and its cofactors. In this study, a total of 38 conjunctival samples from 38 patients, including 12 healthy conjunctivas, 12 melanomas, seven squamous cell carcinomas, and seven papilloma samples, were analyzed using high‐throughput RNA sequencing to assess messenger RNA (mRNA) expression of the SARS‐CoV‐2 receptor ACE2 and its cofactors including TMPRSS2, ANPEP, DPP4, and ENPEP. ACE2 protein expression was assessed in eight healthy conjunctival samples using immunohistochemistry. Our results show that the SARS‐CoV‐2 receptor ACE2 is not substantially expressed in conjunctival samples on the mRNA (median: 0.0 transcripts per million TPM, min: 0.0 TPM, max: 1.7 TPM) and protein levels. Similar results were obtained for the transcription of other auxiliary molecules. In conclusion, this study finds no evidence for a significant expression of ACE2 and its auxiliary mediators for cell entry in conjunctival samples, making conjunctival infection with SARS‐CoV‐2 via these mediators unlikely.
Highlights ► We estimated the annual direct medical costs attributable to HPV in the USA. ► The overall annual direct medical cost burden was estimated to be $8.0 billion. ► Most of this cost was for ...cervical cancer screening and follow-up ($6.6 billion).
Background
Papillomavirus infections in dogs have a variety of manifestations and involve multiple viral genera. Canine pedal papillomas have been infrequently studied and reported in the literature.
...Objective
To report the signalment, history, treatment and outcome of biopsy‐confirmed cases of canine pedal papillomatosis, collected from veterinarians across the United States and Canada
Animals
Medical records from 44 dogs were submitted by North American veterinarians.
Methods and materials
Surveys were submitted through the Veterinary Information Network for biopsy‐confirmed cases of canine pedal papillomatosis. Submissions included information on patient signalment, history, biopsy report, treatment and outcome.
Results
Forty‐four cases were reviewed. The median age of presentation was four years old. Dogs most commonly presented with lameness and/or paw licking/chewing. Only one paw was affected in 35 cases, and front paws were more often affected than back paws. Twenty‐eight dogs presented with one mass. Histopathological evaluation documented 33 cases of noninverted papillomas and 11 cases of inverted papillomas. Thirty‐four papillomas resolved in total; 25 resolved within three weeks after biopsy collection. Twenty‐one dogs received no additional treatment and 15 of those cases resolved. Azithromycin was the most commonly reported treatment initiated after biopsy was collected.
Conclusions and clinical importance
The biological behaviour of canine pedal papillomas in this case series was similar to oral papillomas, and most lesions resolved with or without additional treatment. Further research is needed to better characterise the causative papillomavirus types and genera involved in the development of canine pedal papillomas.
Résumé
Contexte
Les papillomaviroses du chien ont de multiples manifestations et impliquent de multiples genres viraux. Les papillomes podaux canins ont été rarement étudiés et décrits dans la littérature.
Objectif
Décrire le signalement, les commémoratifs et l’évolution de cas confirmés par biopsie de papillomatose podale canine, collectés par des vétérinaires aux Etats Unis et Canada.
Sujets
Les données médicales de 44 chiens ont été soumises par les vétérinaires nord‐américains.
Méthodes
Les études ont été soumises via le réseau d’information vétérinaire pour les cas confirmés par biopsie de papillomatose podale canine. Les soumissions comprenaient des informations sur le signalement, les commémoratifs, le traitement et l’évolution du patient.
Résultats
Quarante quatre cas ont été revus. L’âge moyen de présentation était de quatre ans. Les chiens présentaient le plus fréquemment une boiterie et/ou léchage/mordillement des coussinets. Seul un coussinet était atteint dans 35 cas et les pattes antérieures étaient plus souvent affectées. Vingt huit chiens présentaient une masse. L’examen histopathologique documentait 33 cas de papillomes non‐inversés et 11 cas de papillomes inversés. Trente‐quatre papillomes se sont résolus au total ; 25 en trois semaines après biopsie. Vingt et un chiens ont reçu un traitement additionnel et 15 de ces cas se sont résolus. L’azithromycine était le traitement le plus fréquemment initié après biopsie.
Conclusions et importance clinique
L’évolution biologique des papillomes podaux canins dans cette série de cas est semblable aux papillomes oraux, et la plupart des lésions se résolvent avec ou sans traitement additionnel. D’autres recherches sont nécessaires pour mieux caractériser les types de papillomavirus en cause et les genres impliqués dans le développement des papillomes podaux canins.
Resumen
Introducción
las infecciones por virus del papiloma en perros tienen una variedad de manifestaciones e involucran múltiples géneros virales. Los papilomas podales canino se han estudiado y se han descrito con poca frecuencia en la literatura.
Objetivo
describir la presentación, historia clínica, tratamiento y resultado de casos confirmados por biopsia de papilomatosis podal canina, obtenidos de veterinarios de los Estados Unidos y Canadá.
Animales
veterinarios norteamericanos enviaron los hisstoriales médicos de 44 perros.
Métodos
Se enviaron encuestas a través de la Red de información veterinaria (VIN) buscando casos de papilomatosis pediátrica canina confirmados por biopsia. Los casos admitidos incluyeron información sobre demografía del paciente, el historial, el informe de biopsia, el tratamiento y el resultado.
Resultados
se revisaron cuarenta y cuatro casos. La mediana de edad de presentación fue de cuatro años. Los perros se presentaron más frecuentemente con cojera y/o lamido/mordedura de las patas. Una sola extremidad se vio afectada en 35 casos, y las extremidades delanteras se vieron afectadas con más frecuencia que las traseras. Veintiocho perros se presentaron con una masa. La evaluación histopatológica documentó 33 casos de papilomas no invertidos y 11 casos de papilomas invertidos. Treinta y cuatro papilomas se resolvieron en total; 25 se resolvieron dentro de las tres semanas posteriores a la extracción de la biopsia. Veintiún perros no recibieron tratamiento adicional y 15 de esos casos se resolvieron. La azitromicina fue el tratamiento reportado con más frecuencia que se inició después de la obtención de la biopsia.
Conclusiones e importancia clínica
el comportamiento biológico de los papilomas podales caninos en esta serie de casos fue similar al de los papilomas orales y la mayoría de las lesiones se resolvieron con o sin tratamiento adicional. Se necesitan más investigaciones para caracterizar mejor los tipos y géneros de papilomavirus causantes involucrados en el desarrollo de papilomas podales caninos.
Zusammenfassung
Hintergrund
Papillomavirus Infektionen bei Hunden manifestieren sich in unterschiedlichster Form und umfassen multiple Virenstämme. Papillomata an den Füssen von Hunden sind bisher noch selten untersucht und in der Literatur beschrieben worden.
Ziel
Ein Bericht über Signalement, Anamnese, Behandlung und Endergebnis von Papillomata an den Füssen von Hunden, die mittels Biopsie bestätigt worden waren. Die Proben stammten von TierärztInnen aus den United States und aus Kanada.
Tiere
Medizinische Daten von 44 Hunden wurden von TierärztInnen aus Nordamerika eingesendet.
Methoden
Es wurden Fragebögen für Fälle von Papillomata an den Füssen von Hunden, die durch Biopsie bestätigt waren, durch ein veterinärmedizinisches Informationsnetzwerk ausgesendet. Die Eingänge umfassten Informationen bezüglich Signalements der Patienten, Anamnese, Biopsieberichte, Behandlung und Ergebnisse.
Ergebnisse
Es wurden vierundvierzig Fälle durchgesehen. Das mediane Alter bei der Präsentation lag bei vier Jahren. Die Hunde wurden am häufigsten mit Lahmheit und/oder Pfotenlecken/‐beißen vorgestellt. In 35 Fällen war nur eine Pfote betroffen, wobei es sich häufiger um die Vorder‐ als um die Hinterpfoten handelte. Achtundzwanzig Hunde wurden mit einer Masse vorgestellt. Histopathologisch wurden 33 Fälle mit nicht invertierten und 11 Fälle mit invertierten Papillomata dokumentiert. Insgesamt vierunddreißig Papillomata verschwanden; 25 verschwanden innerhalb von drei Wochen nach der Biopsieentnahme. Einundzwanzig Hunde bekamen keine zusätzliche Behandlung und 15 dieser Fälle heilten spontan ab. Azithromyzin war die am häufigsten dokumentierte Behandlung nachdem die Biopsie entnommen worden war.
Schlussfolgerungen und klinische Bedeutung
Das biologische Verhalten von Papillomata an den Füssen von Hunden in dieser Fallserie war ähnlich wie bei oralen Papillomata, und die meisten Läsionen verschwanden mit oder ohne zusätzliche Behandlung. Weitere Studien sind nötig, um die ursächlichen Papillomavirus Typen und die involvierten Stämme, die bei der Entstehung von caninen Papillomata an den Füssen eine Rolle spielen, besser zu charakterisieren.
要約
背景
犬のパピローマウイルス感染症は様々な症状を呈し、複数のウイルス属が関与している。犬の足底乳頭腫の研究・報告はほとんど行われていない。
目的
本研究の目的は、アメリカおよびカナダの獣医師から収集した犬の足底乳頭腫症の生検で確認された症例のシグナルメント、病歴、治療、転帰を報告することであった。
供試動物
北米の獣医師から44頭の犬の医療記録が提出された。
方法
Veterinary Information Networkを介して、犬の足底乳頭腫症の生検確認例についての調査が提出された。提出された情報には、患者のシグナルメント、病歴、生検記録、治療、治療成績に関する情報が含まれていた。
結果
44症例が検討された。症例の年齢の中央値は4歳であった。犬は最も一般的に、跛行および/または肉球の舐め/噛みを呈した。35例では片側前肢のみが侵されており、前肢が後肢よりも多く罹患していた。28頭の犬が1つの腫瘤を有していた。病理組織学的には、33例が非反転性乳頭腫、11例が反転性乳頭腫であった。合計34例の乳頭腫は消失し、25例は生検採取後3週間以内に消失した。21頭の犬は追加治療を受けず、そのうち15例が治癒した。アジスロマイシンは生検採取後に開始された治療として最も多く報告された。
結論と臨床上の重要性
このケースシリーズにおける犬の足底乳頭腫の生物学的挙動は口腔内乳頭腫と類似しており、ほとんどの病変は追加治療を受けても受けなくても治癒した。犬の足部乳頭腫の発症に関与する原因パピローマウイルスの型および属をより明確にするためには、さらなる研究が必要である。
摘要
背景
犬乳头瘤病毒感染有多种表现, 涉及多个病毒属。犬爪垫乳头状瘤的研究较少, 文献报道较少。
目的
报告从美国和加拿大兽医采集的、经活检证实的、犬爪垫乳头状瘤病病例的病征、病史、治疗和效果
动物
由北美兽医提交44只犬的病历。
方法
通过兽医信息网络, 提交调查活检确诊的犬爪垫乳头状瘤病病例。提交内容包括病征、病史、活检报告、治疗和效果信息。
结果
调查了44个病例。就诊中位年龄为4岁。犬最常表现为跛行和/或舔爪/啃咬。35例仅1只爪垫发病, 前爪发病多于后爪。28只犬出现1个肿块。组织病理学评价记录了33例非内翻性乳头状瘤和11例内翻性乳头状瘤。34例乳头状瘤全部消退; 25例在活检采集后3周内消退。21只犬未接受额外治疗, 其中15例病例消退。阿奇霉素是采集活检样本后开始治疗的最常报告药物。
结论和临床重要性
该病例系列中犬爪垫乳头状瘤的生物学行为与口腔乳头状瘤相似, 大多数病变在接受或未接受额外治疗的情况下消退。需要进一步研究, 以更好地描述导致犬爪垫乳头状瘤发病的乳头瘤病毒类型和属。
Resumo
Contexto
Infecções por papilomavírus em cães possuem uma variedade de manifestações e envolvem múltiplos gêneros de vírus. Os papilomas podais caninos têm sido pouco estudados e relatados na literatura.
Objetivo
Relatar os sinais clínicos, histórico, tratamento e evolução de casos de papilomatose podal canina confirmados por biópsia, atendidos por veterinários nos Estados Unidos e Canadá.
Animais
Os prontuários de 44 cães foram submetidos por veterinários norteamericanos.
Métodos
Os casos de papilomatose podal confirmados por biópsia foram submetidos pelo sistema Veterinary Information Network. As submissões incluíram informações dos sinais clínicos do paciente, histórico, laudo de biópsia, tratamento e evolução.
Resultados
Quarenta e quatro casos foram revisados. A idade mediana de apresentação foi de quatro anos de idade. Os sinais clínicos mais comumente apresentados pelos animais foram claudicação e/ou lambedura/mordedura das patas. Vinte e oito cães apresentaram apenas uma massa.
Patients with pathological nipple discharge (PND) often undergo local surgical procedures because standard radiologic imaging fails to identify the underlying cause. MicroRNA (MiRNA) expression ...analysis of nipple fluid holds potential for distinguishing between breast diseases. This study aimed to compare miRNA expression levels between nipple fluids from patients with PND to identify possible relevant miRNAs that could differentiate between intraductal papillomas and no abnormalities in the breast tissue. Nipple fluid samples from patients with PND without radiological and pathological suspicion for malignancy who underwent a ductoscopy procedure were analyzed. We used univariate and multivariate regression analyses to identify nipple fluid miRNAs differing between pathologically confirmed papillomas and breast tissue without abnormalities. A total of 27 nipple fluid samples from patients with PND were included for miRNA expression analysis. Out of the 22 miRNAs examined, only miR-145-5p was significantly differentially expressed (upregulated) in nipple fluid from patients with an intraductal papilloma compared to patients showing no breast abnormalities (OR 4.76,
= 0.046), with a diagnostic accuracy of 92%. miR-145-5p expression in nipple fluid differs for intraductal papillomas and breast tissue without abnormalities and, therefore, has potential as a diagnostic marker to signal presence of papillomas in PND patients. However, further refinement and validation in clinical trials are necessary to establish its clinical applicability.
PDF
