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Kendra A. Klein, Swathi Kaliki, Eralda Hysenj, Carol L. Shields; Conjunctival Papilloma features and outcomes in 70 consecutive patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3988.
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© ARVO (1962-2015); The Authors (2016-present)
To describe clinical features and outcomes of treatment of conjunctival papilloma.
Retrospective chart review of 70 patients with 91 tumors.
The mean age at presentation of conjunctival papilloma was 47 years, with 14 tumors (15%) in children (≤20 years) and 77 tumors (85%) in adults (>20 years). The most common presenting symptom included mass (n=26; 37%) or a red spot (n=15; 21%). The tumor was located on the bulbar conjunctiva (n=23; 25%), caruncle (n=18; 20%), the forniceal conjunctiva (n=15; 17%), tarsal conjunctiva (n=14; 15%), plica semilunaris (n=13; 14%), lid margin (n=4; 4%), limbus (n=3; 3%), and punctum (n=1; 1%). The mean tumor basal diameter was 8 mm (millimeters) (median, 6 mm; range, 1 to 35 mm), and mean tumor thickness was 3 mm (median, 3 mm; range, 0.5 to 10 mm). The tumors were treated by surgical excision using the "no touch technique" and cryotherapy (n=59; 65%), plus supplemental oral cimetidine (n=8; 9%), or plus supplemental interferon (n=5; 6%). Sole treatment was given with oral cimetidine alone (n=6; 7%), topical interferon alone (n=4; 4%), photodynamic therapy alone (n=1; 1%), or cryotherapy alone (n=1; 1%). Cautious observation was employed in 3% (n=3), and 4% (n=4) were lost to follow-up. Associated conjunctival intraepithelial neoplasia was present in 8% (n=7), and invasive squamous cell carcinoma in 5% (n=5) cases. Recurrence of papilloma was noted in 5% (n=5) cases over a mean follow-up period of 50 months (median, 14; range 1 to 629 months). Of the five with recurrence, four achieved complete tumor regression (n=4; 80%) by further surgical excision and cryotherapy with supplemental oral cimetidine (n=2; 50%), supplemental interferon alpha-2b injection (n=1; 25%), or oral cimetidine alone (n=1; 25%).
Conjunctival papilloma presents on the bulbar conjunctiva (25%), caruncle (20%), or fornix (17%) in both children and adults. Surgical excision plus cryotherapy plus supplemental oral cimetidine or interferon alpha-2b therapy ultimately control 99% of cases.
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