Squamous papilloma of the oral cavity and oropharynx in children.

OBJECTIVE: Squamous papillomas (SP) of the oral cavity and oropharynx are infrequently described yet commonly encountered in pediatric practice. This study characterizes our institutional experience, emphasizing the detection of high-risk human papillomavirus (HPV) subtypes and implications for surveillance. METHODS: A retrospective chart review was performed using electronic health records from January 1, 2004, to January 1, 2024. The search utilized ICD-10 codes D10.1, D10.39, D10.4, and D10.41 for benign neoplasms of the oral cavity and oropharynx. Patients with papillomas of the larynx, trachea, and esophagus were excluded. All patients were evaluated by an otolaryngologist, underwent excisional biopsy, and had SP confirmed on pathology. Data regarding HPV testing and follow-up outcomes were reviewed. RESULTS: Fifty-nine patients (mean age 13.0 years) were identified. Lesions were most commonly located on the uvula (n = 27), followed by the tonsillar region (n = 18), soft palate (n = 6), and hard palate (n = 4). Most lesions were incidentally discovered. HPV typing, performed in 34 patients (57.6 %), yielded 7 positive cases (2 low-risk, 5 high-risk); notably, no patient with prior HPV vaccination tested positive. Follow up was available in 25 patients (42.4 %) at a mean of 74.7 days post-excision, with no recurrences observed. CONCLUSIONS: Although SPs are generally solitary and incidentally discovered, a subset of pediatric patients exhibits high-risk HPV. Advances in HPV testing now enable detection of a broader range of subtypes, underscoring the need for routine HPV typing and tailored surveillance to mitigate potential long-term HPV-related sequelae.