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Red Lump In Mouth. Diagnosed As Papilloma, Benign Substance And Injury. Worried About HPV

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Posted on Tue, 25 Sep 2012
Question: For the past month, I have noticed a reddish lump on the border between my hard and soft palate. I saw three doctors, all three of them gave me different diagnoses. One of them said that it was a minor damage to my oral epithelium, and I have nothing to worry about. The other doctor said that it was "something benign" (quoting the exact words), and then again, that I have nothing to worry about. An ENT specialist told me that I have a papilloma. Now, this lump looks nothing like a papilloma to me ( I am a biology graduate student and have reviewed countless scientific papers and pictures online). I naturally freaked out because of HPV, and saw another doctor, who told me that "the colleague most likely (!! I don't know how these people have their licence!!) meant that you have a benign formation by saying papilloma, and that it does not look like that type" and that most likely I shouldn't worry about HPV. Having cotracted HPV is highly unlikely: I have had a serious girlfriend for a while, have not engaged in any promiscuous acts, and this lesion appeared during a period of high stress only last month. I am a moderate smoker (don't smoke every day, XXXXXXX 4 cigarettes), but I'm still worried about potential for malignancy. Basically, I am looking for an additional opinion on that lesion.
doctor
Answered by Dr. Sudarshan (45 minutes later)
Hi Dear,

Ive gone through your query and photos uploaded .

A close up photograph would however be more informative.

I would agree with your ENT specialist with the diagnosis of papilloma.

Papilloma is a general medical term for a tumor of the skin or mucous membrane with finger-like projections.

Majority of papillomas are benign (noncancerous), they can occasionally be precancerous or malignant (cancerous).

Most papillomas are caused by a virus. The human papillomaviruses (HPVs) are a group of more than 150 viruses that can cause papillomas.

Some types of papilloma have other, nonviral, causes. For example, oral cavity papilloma may be caused by a tissue injury.

You seem to have the NON viral type of papilloma. It can be caused by nonspecific trauma sustained while brushing or eating food.

We have encountered such growths in our patients.
Biopsy of which reveals benign epithelial proliferation.

There is nothing to be worried about it as they are NON VIRAL and NON cancerous.

A watchful waiting is all that is required.
If its not resolved in 2-3 months or causes symptoms
a excision biopsy can be done .Which will be both diagnostic and therapeutic.

Hope ive made myself clear.

If you need any further clarification do let me know.

Regards
DrSudarshan.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan (26 minutes later)
Dear Dr. Sudrashan,
Thank you so much for your reply. It provided considerable relief. I guess the internet may be highly misleading in the aspect that the only link that they provide to oral papillomas is HPV. (In fact, some website say that "ALL papillomas are caused by HPV"), which naturally leads to patient anxiety at the very least. I have another question regarding the need to make potential changes in my lifestyle. As I mentioned in my earlier post, I am a moderate smoker. I am well aware of the consequences of this habit, and have a desire to quit in the near future. However, due to work stress, I can't really afford to go through withdrawals again without negatively impacting productivity. NRT doesn't work for me either because of my functional dyspepsia. So, my question is, if I continue smoking, would that increase the probability of this particular lesion becoming malignant more so than any other tissue exposed to tobacco smoke? In other words, would this particular tissue have already some amounts of genetic "hits", and thus more likely to become malignant if exposed to the carcinogens in tobacco smoke than if it was normal epithelium?
doctor
Answered by Dr. Sudarshan (15 minutes later)
Hi again,

Cigarette smoking can certainly cause dysplastic change .

Usual sequence is benign-->dysplastic(pre cancerous)-->malignant (cancerous).

The smoking can cause all types of changes. It can also cause malignancy in situ.

Smoking can turn benign papilloma into malignancy.

Its better you quit the habit.



Pls let me know if you need further clarification.

If you are satisfied with answer please accept it and rate it at the end.

I will be available for follow up in future.

Regards.
Dr XXXXXXX
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudarshan

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Practicing since :2005

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Red Lump In Mouth. Diagnosed As Papilloma, Benign Substance And Injury. Worried About HPV

Hi Dear,

Ive gone through your query and photos uploaded .

A close up photograph would however be more informative.

I would agree with your ENT specialist with the diagnosis of papilloma.

Papilloma is a general medical term for a tumor of the skin or mucous membrane with finger-like projections.

Majority of papillomas are benign (noncancerous), they can occasionally be precancerous or malignant (cancerous).

Most papillomas are caused by a virus. The human papillomaviruses (HPVs) are a group of more than 150 viruses that can cause papillomas.

Some types of papilloma have other, nonviral, causes. For example, oral cavity papilloma may be caused by a tissue injury.

You seem to have the NON viral type of papilloma. It can be caused by nonspecific trauma sustained while brushing or eating food.

We have encountered such growths in our patients.
Biopsy of which reveals benign epithelial proliferation.

There is nothing to be worried about it as they are NON VIRAL and NON cancerous.

A watchful waiting is all that is required.
If its not resolved in 2-3 months or causes symptoms
a excision biopsy can be done .Which will be both diagnostic and therapeutic.

Hope ive made myself clear.

If you need any further clarification do let me know.

Regards
DrSudarshan.