The New England Journal of MedicineConjunctival Papilloma

Human Papillomavirus-Associated Conjunctival Papilloma: Diagnosis and Management in Young Adults

A recent case report illustrates the presentation, diagnosis, and treatment of conjunctival papilloma in a young adult. This common benign tumor of the eye, often associated with human papillomavirus (HPV), presents unique challenges in diagnosis and management, reinforcing the importance of recognizing characteristic clinical features and considering appropriate treatment options for optimal patient outcomes.

Key Points:

• A 26-year-old man presented with a 2-month history of a painless, reddish growth on his left eye.
• Physical examination revealed a sessile mass protruding above the lower eyelid.
• The mass exhibited vascular fronds and an episcleral feeder vessel on the inferior bulbar conjunctiva.
• Mild conjunctival hyperemia was observed, with no cutaneous lesions present.
• Surgical excision with cryotherapy was performed as the treatment of choice.
• Histopathological evaluation confirmed the diagnosis of conjunctival papilloma.
• Conjunctival papilloma is one of the most common benign tumors of the eye.
• The condition primarily affects young adults and is associated with HPV.
• The patient had not been vaccinated against HPV.
• Characteristic appearance includes a well-demarcated sessile or exophytic papule with “hairpin” vessel loops.
• This distinctive appearance helps differentiate conjunctival papilloma from malignant lesions.
• Management options include local therapy with interferon alfa-2b, surgery with cryotherapy, or a combination of both.
• At the 3-month follow-up, there was no recurrence of the lesion.

Overall, conjunctival papillomas account for 1 to 16% of conjunctival lesions seen in adults and 1 to 10% of the lesions seen in children and adolescents. (Eye Vis (Lond))

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