ABSTRACT.Purpose: To determine morphological and clinical characteristics of conjunctival papilloma. Methods: Specimens of conjunctival papilloma registered during the period 1983-1997 were collected. For each case the patient's sex and age, number of papillomas/patient, seasonal debut, duration, number of recurrences, localisation and presence of dysplasia and/or inflammation in the papilloma were registered. Results: A total of 245 papillomas in 219 patients were found. 132 (60.3%) of the patients were males. The age distribution showed skewness to the left with a peak in the age groups 20-29 years and 30-39 years. No variation of seasonal debut was found. 14 patients (6%) had more than one papilloma concurrently. 24 (11%) of the patients had recurrence. Most of the papillomas were located medially and inferiorly. 98 (40%) of the papillomas were inflamed. 14 (6%) of the papillomas were dysplastic.
Conclusion:The conjunctival papilloma is a common tumour. More males than females develop conjunctival papillomas and the incidence is highest among patients aged 20-39 years. The conjunctival papilloma is primarily located medially and inferiorly.Key words: papilloma -conjunctiva -localisation -dysplasia -sex -age -distribution. T he squamous cell papilloma of the conjunctiva is a benign and common epithelial tumour.Conjunctival papillomas may have an exophytic, mixed or inverted growth pattern (Conlon et al. 1994;Streeten et al. 1979). The exophytic configuration may be sessile or pedunculated. Inverted papillomas of the conjunctiva are very rare (Streeten et al. 1979).Dysplasia may be observed, but carcinoma rarely develops in a conjunctival papilloma (Zimmerman 1980).In a study of 1016 epibulbar lesions (Ash 1950) the conjunctival papilloma was found to be the second most frequent epithelial lesion and the conjunctival papilloma is an equally frequent lesion of the caruncle (Santos & Gó mez-Leal 1994).The aetiology of the conjunctival papilloma is not known, but it has been associated with human papillomavirus (HPV) types 6,11 and 16 (McDonnell et al. 1987;Saegusa et al. 1995). HPV types 16 and 18 have in addition been found in normal conjunctival tissue (Karcioglu 1997).
Material and MethodsThe files at the Eye Pathology Institute, University of Copenhagen, Denmark were reviewed for the period 1983 to 1997, included. Specimens diagnosed as a conjunctival papilloma were identified.The following data were registered from the pathology referral forms: the patient's sex and age, number of papillomas/patient, seasonal debut of the papilloma, duration, number of recurrences, the affected eye (right or left), localisation and presence of dysplasia and/or inflammation in the papilloma.A chi-squared test was used in order to test for associations between the following parameters: sex and localisation of the papilloma, localisation and affected eye and sex and age-distribution. A probability level of pϽ0.05 was considered significant.
ResultsA total number of 245 papillomas in 219 patients were registered. The chi-squared...