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Have Tonsil Papilloma. Throat Swab Test Normal. Could It Be Due To HPV?
Question: HI
I am 34. I have tonsil papilloma (One single growth from the left tonsil which projects outwards)on my left tonsil,it is present there from march 2011 onwards,the left tonsil is not symmetical when compared to right tonsil,please let me know if this papilloma of tonsil if left untreated,will turn into cancer by time,as of now there is no problem with the papilloma.I can eat food,swallow it comfortably,ther is no problem with it.ENT specialist has told this papilloma is a result of a certain virus type HPV(please let me know the virus which causes papilloma on tonsil has the potential to turn the papilloma into cancer with time) ,Is there any treatment to kill the virus or is there any test to identify the presence of HPV virus in papilloma.I have done a test on throat swab.The result was negative.Report is attached herewith
Regards
XXXXXXX
I am 34. I have tonsil papilloma (One single growth from the left tonsil which projects outwards)on my left tonsil,it is present there from march 2011 onwards,the left tonsil is not symmetical when compared to right tonsil,please let me know if this papilloma of tonsil if left untreated,will turn into cancer by time,as of now there is no problem with the papilloma.I can eat food,swallow it comfortably,ther is no problem with it.ENT specialist has told this papilloma is a result of a certain virus type HPV(please let me know the virus which causes papilloma on tonsil has the potential to turn the papilloma into cancer with time) ,Is there any treatment to kill the virus or is there any test to identify the presence of HPV virus in papilloma.I have done a test on throat swab.The result was negative.Report is attached herewith
Regards
XXXXXXX
Hello
I am Dr Ravinder Sharma ENT surgeon
On the basis of the information provided and the reports attached and the opinion of the ENT surgeon (as quoted) I would consider the diagnosis as Papilloma tonsil. It is a rare lesion of the tonsil. There is no role of medical treatment at this stage. Getting into the literature to look for the incidence of malignant transformation for a rare lesion will not land you anywhere. There has been some association in recent literature in aerodigestive and laryngeal malignancy and human papilloma virus. The pattern of such articles cannot be the basis of the treatment in such situation.
Now about the test for this disease --- How does it change the treatment if the report comes as positive or negative. When the treatment does not change with the test result I think it is appropriate to avoid this test and plan for surrgical excision. With the asymmetrical size of this tonsil I would advise you to plan for a unilateral tonsillectomy and the histopathology of the lesion. This may be curative too. In case there has been some kind of malignant (cancerous) transformation this can be better seen under microscope in the excised specimen. The opinions of two ENT surgeons may vary but histopathology of the excised specimen is the most accurate test. Tonsillectomy is a simple day care surgery and can solve this riddle
I would be happy to help you further if you can provide me a photograph of the lesion(if possible).
I hope this answers your concern. Feel free to contact me if you have any more questions about it
with regards
Ravinder Sharma
I am Dr Ravinder Sharma ENT surgeon
On the basis of the information provided and the reports attached and the opinion of the ENT surgeon (as quoted) I would consider the diagnosis as Papilloma tonsil. It is a rare lesion of the tonsil. There is no role of medical treatment at this stage. Getting into the literature to look for the incidence of malignant transformation for a rare lesion will not land you anywhere. There has been some association in recent literature in aerodigestive and laryngeal malignancy and human papilloma virus. The pattern of such articles cannot be the basis of the treatment in such situation.
Now about the test for this disease --- How does it change the treatment if the report comes as positive or negative. When the treatment does not change with the test result I think it is appropriate to avoid this test and plan for surrgical excision. With the asymmetrical size of this tonsil I would advise you to plan for a unilateral tonsillectomy and the histopathology of the lesion. This may be curative too. In case there has been some kind of malignant (cancerous) transformation this can be better seen under microscope in the excised specimen. The opinions of two ENT surgeons may vary but histopathology of the excised specimen is the most accurate test. Tonsillectomy is a simple day care surgery and can solve this riddle
I would be happy to help you further if you can provide me a photograph of the lesion(if possible).
I hope this answers your concern. Feel free to contact me if you have any more questions about it
with regards
Ravinder Sharma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi XXXXXXX XXXXXXX
Thanks for the answers,Excision of the tonsil is recommended by you.But is it risk free surgery?.Only the excision of papilloma is fine?.The image of the papilloma is uploaded for your reference,please comment on this growth.I'm not facing any problem with this growth,only worry is that in a long run (increasing age) will this abnormal growth turn to cancer?.
Regards
XXXXXXX
Thanks for the answers,Excision of the tonsil is recommended by you.But is it risk free surgery?.Only the excision of papilloma is fine?.The image of the papilloma is uploaded for your reference,please comment on this growth.I'm not facing any problem with this growth,only worry is that in a long run (increasing age) will this abnormal growth turn to cancer?.
Regards
XXXXXXX
Hello
Thanks for your follow up query
I have seen photograph the clinical diagnosis appears to be papilloma.
Tonsillectomy is a pretty safe surgery and will take care of any spread of disease at cellular level(if it is so)
Excision of tumour is a relatively small procedure but carries a risk of recurrence
I understand your concern and if you plan for a excision of papilloma only I would advise you for monthly follow up at least for 6 months and than 3 monthly follow up for 2 years to look for any recurrence or residual growth at that point. In case there is any growth at that point you can plan for tonsillectomy.
I hope this answers your concern. Feel free to contact me if you require more information about it
with regards
Ravinder Sharma
Thanks for your follow up query
I have seen photograph the clinical diagnosis appears to be papilloma.
Tonsillectomy is a pretty safe surgery and will take care of any spread of disease at cellular level(if it is so)
Excision of tumour is a relatively small procedure but carries a risk of recurrence
I understand your concern and if you plan for a excision of papilloma only I would advise you for monthly follow up at least for 6 months and than 3 monthly follow up for 2 years to look for any recurrence or residual growth at that point. In case there is any growth at that point you can plan for tonsillectomy.
I hope this answers your concern. Feel free to contact me if you require more information about it
with regards
Ravinder Sharma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr.Ravinder XXXXXXX
Thanks for the answer regarding tonsil excision.But the question for my second concern is not answered,please let me know if this tonsil papilloma(image attached) if left untreated (left as such without any treatment)as age increases, is there any risk that this tonsil papilloma will turn into cancer?,as per your experience and knowledge do you know any case where tonsil papilloma turned into cancer in a long run?,or tonsil papilloma will remain as such without any change in a long run?,is this tonsil papilloma caused by HPV virus or is it due to some other reason ?,please answer this question also so that we can wind up this discussion.
Regards
XXXXXXX
Thanks for the answer regarding tonsil excision.But the question for my second concern is not answered,please let me know if this tonsil papilloma(image attached) if left untreated (left as such without any treatment)as age increases, is there any risk that this tonsil papilloma will turn into cancer?,as per your experience and knowledge do you know any case where tonsil papilloma turned into cancer in a long run?,or tonsil papilloma will remain as such without any change in a long run?,is this tonsil papilloma caused by HPV virus or is it due to some other reason ?,please answer this question also so that we can wind up this discussion.
Regards
XXXXXXX
Hello
Thanks for the follow up query
I have already seen the photograph sent with your query and had given my opinion after seeing the photograph
If left untreated it may turn into cancer or it may not turn into cancer. I hope you got my point that there is a risk for the development of cancer but we cannot predict that this will surely happen in a particular case. I feel if you have a relatively more risk of deveoping cancer you will try to reduce or remove the risk factor .
Most likely cause of papilloma of larynx is Human Papilloma Virus but there//
can be other causes of papilloma larynx. In medicine, there are no rules and there can be exceptions and it's never a 2+2 = 4 situation.
I have answered your query and if you feel you require more clarifications please write back.
with warm regards
Ravinder Sharma
Thanks for the follow up query
I have already seen the photograph sent with your query and had given my opinion after seeing the photograph
If left untreated it may turn into cancer or it may not turn into cancer. I hope you got my point that there is a risk for the development of cancer but we cannot predict that this will surely happen in a particular case. I feel if you have a relatively more risk of deveoping cancer you will try to reduce or remove the risk factor .
Most likely cause of papilloma of larynx is Human Papilloma Virus but there//
can be other causes of papilloma larynx. In medicine, there are no rules and there can be exceptions and it's never a 2+2 = 4 situation.
I have answered your query and if you feel you require more clarifications please write back.
with warm regards
Ravinder Sharma
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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