Medical Questions? Ask a Doctor Online!
Thanks for your reply. Just for health history. I had a bone marrow transplant due to CML (leukemia) in 1994. I am not on any immunosupressant drugs and may have been only initially after transplant.
I'm 38/female. In Feb 2013, I coughed up a papilloma. I took it for pathology. It was found as benign squamous epithelial papilloma. I'm posting a photo of the one I coughed up.
Then in June 2013, I found a papilloma growing off the front left side of my uvula. I had it removed in the ENT office and he sent it for pathology. It came back as moderate dysplasia (also called high grade) with hpv cellular changes.
Now, last week, the ENT did a flexible larynoscopy through my nose in his office. He saw another papilloma again on my uvula except this time on the back left side of uvula. He said it does not "look cancerous" and that it's small. I want this thing out ASAP so I'm scheduled for outpatient surgery next week.
My questions are, I can't seem to find much info. about these growths other than related to RRP. Maybe this is the beginning of adult onset RRP. I find info. about oral papillomas and most everything says they are usually benign and rarely cancerous. Is my situation so unheard of? Have you seen this before? I'm very scared about this. Any info. you can provide is greatly appreciated.
Here's the photo of the one I coughed up that pathology said was benign squamous epithelium. I had the sensation of something stuck in my throat for several months but thought I was imaging it until I coughed this up. I'm not sure if this was on my uvula as well or if it was on vocal cords.
Hmmm.....no I don't think so. What I do have is running nose that seems to have gotten better within the last couple days. The ENT said he saw a lot of mucus but it was clear in color. When my nose was runny and full of mucus, my ears felt clogged (like water in the ear) but no pain. During this time I would cough up yellowish colored phlegm once or twice per day. Just in the last couple days this has gotten somewhat better. I'd clear my throat some during the day because of the phlegm but I can't say I've really noticed hoarseness.
Wouldn't the flexible larynoscopy I had in the office find the cause of the symptoms you describe above?
Thanks so much for the home remedy. I will try this. I've never had allergies and live in Georgia where pollen can be horrible. But I've heard allergies can develop suddenly.
Have you ever seen or heard of a dysplastic papilloma or seen one in your practice? Do papillomas of the uvula tend to spread to the vocal cords as well? Doesn't dysplasia (especially moderate as was my growth) usually turn to cancer if untreated?
I feel like I have some rare disease that I will eventually succumb to. I guess this is due to my history with bone marrow transplant and I know this makes me more susceptible to solid cancers.
When I looked up laryngeal papillomas I was able to find information about RRP turning into cancerous lesions.
If I were your patient, would you recommend aggressive monitoring and is dysplasia not concerning in a papilloma?
Thanks so much for your help and all the information and patience in answering my questions and your kindness. I may come back to you in the future with additional questions.
If I could please ask a couple follow up questions?
1. 3/4 of my uvula turned white and fell off. Is this typical for something like this to occur?
2. Surgery on my uvula was this past Tuesday. Thursday I felt like I had a "hair" on my tongue. I quickly realized there was nothing there. It's on the underside left side. It's almost like a numb feeling and it's extra sensitive. I don't see anything there other than this lumpy looking area I circled and included a photo. When I touch that bumpy area, it just feels like normal tongue. Another words, it does not feel like a hard lump or anything. Does this look like something abnormal or can one underside area of the tongue be "lumpier" than the other? I don't know that I've ever noticed this before so I can't say if it was there before.
I'm posting the photo next.
When you say the "overlying skin/mucosa is perfectly normal", does that mean it looks normal from the photo I posted OR because of my description that it feels like normal tongue tissue?
And also, you are saying the 3/4 of my uvula that broke off will regrow?
Yes, here's the photo. I just took it. I know it looks like I have a uvula but it used to be 3/4 more than what's there now. You can see there's still a white area but the area that fell off had gotten longer and longer until it was like a big white bulb that was gagging me. Also, along the edge where I attempted to circle with my paint tool, it's bright red and raw looking there. Hard to see that in this photo.
It was strange to have a part of my mouth fall off and swallow it while sleeping. I am a little relieved, just concerned about the biopsy results of the papilloma on the back of the uvula and the bumpy underside of tongue but will hope that all is normal. Thank you for your patience and help.
Thank you so very much . I will let you know once I find out.
Hi Dr. Hasan,
I received my uvula papilloma biopsy results. This growth was benign (no dysplasia). I was of course very happy about this.
Another question please, I had some mild pain in my throat on the left side and the doctor took a look and said it looked like an ulcer. I've never in my life that I remember had an ulcer in my throat. Are these things typically benign, can a doctor tell the difference between an ulcer and some other type of growth? I've heard before that ulcers can be a sign of mouth or throat cancer depending on where the ulcer is located of course.
Thanks again for your help.
Well it's been 2 months since my uvula surgery. Today I found on the inside of my cheek, the attached. I tried to take a picture of it and circled it with a draw tool in the photo. This looks to me just like erythroplakia. When I run my finger over this red area, it does not feel any different than my regular skin tissue. I have become somewhat obsessed with my mouth because of the now 3 papillomas I've had over the last 10 months. I look in my mouth with a flashlight 3 times per day (yes I know this sounds crazy) and this red area was not there yesterday. Do you think this looks sinister? It actually looks worse in the photo than in person because of the flash on my camera.
I think it appeared today, it was not there yesterday. No white dots around the area.
No burning sensation at all. I wouldn't even know it was there, I only saw it because I examine my mouth daily.
Hello Dr. Hasan,
If I may please ask one more question. Today I went for my two month check up (surgery back in September to remove the papilloma on the back of my uvula). The doctor that did the surgery examined me today with the fiber optic scope. He said everything looks good so far. He did mention if I remember correctly, adenoid hyperplasia I believe is what he said. He was unconcerned about it and said it's from the silent reflux I have as evidenced by I guess by the look of my throat. He told me to come back in 3 months and said my exam was fine. Isn't hyperplasia a precursor to cancer??? Is this a concerning finding?
I think I do snore yes.You say, "although not common at your age but yes it is possible and not common at all".
Do you mean not uncommon?
Hi again and happy holidays. I went to the ENT for my every two month check at the end of November. Everything was fine and no new papillomas. I seem to frequently get these little growths on the insides of my cheeks around the linea alba. They almost look like little painless ulcers and are usually gone within 24 - 48 hours. Today I noticed one along the other side of my inside cheek, also seems to be around the linea alba but this one is a little more yellowish in color and is protruding moreso than what I've seen in the past. I started thinking, perhaps this is another papilloma. It is very small but I'm wondering if this is the beginning of another papilloma. Have you seen anything like this before? I'm going to post a photo and I have circled the area.
Thanks for the reply. If I may ask one more question please. This morning the yellowish growth looked slightly bigger. Using my finger nail, I rubbed the end slightly and it came off immediately. Here's a picture of what the area looks like now. If this were a papilloma, I would think it would not have come off so easily. I'm still thinking perhaps it was a salivary gland stone?
For example, IF it were a papilloma, would using my fingernail tip the way I did have caused the papilloma to break off? I wasn't really that aggressive with it my fingernail before the growth came off.
I mean to say I was not really that aggressive with my fingernail against the growth before it came off. Also, the way the circled area in the second picture looks is what I commonly seem to get along that linea alba line, where it slightly protrudes out and then it's usually gone within 2 days and then I get another one maybe 3 days later along that same area. Seems to happen way more on the left side although this pic is from the right side. Today the left side has nothing on it.
To you as well.
Hi Dr. Hasan. Sorry to contact you again so soon. Now I am really nervous. It seems that little thing is starting to regrow. This is very alarming......what would regrow so quickly?
Here is another photo with a different camera. It's still difficult to see the little area clearly. Is this photo any better to take a look at it? I don't really think it's bigger but it's still there. The little piece I knocked off has not grown back.
Sorry, I realized the photo was too large. I've resized it and here it is again.
Thanks for your response and for taking a look at another picture. I'm not sure what happened but in approximately 8 - 10 hours, whatever this was on my cheek is now almost gone. Strange because I was convinced it was the beginning of a very small papilloma. It could not be that if it went away that quickly. Anyways, I am very happy about. Each papilloma (I've had 3) has appeared a little over 3 months of each other. Papilloma #1 end Feb 2013, #2 mid June 2013, papilloma #3 mid September 2013. This is around the time I'd expect #4 if the pattern was consistent.
Thank you again.
I know I likely appear obsessive over my mouth and I agree I'm spending too much time focusing on it. I do have another question. Does this photo of my tonsils appear normal?
In one tonsil (the one appearing smaller which would be the one on the right when looking head on at the photo), there is lymphoid tissue on that tonsil that's not on the other side. You can' see it in the photo because the tissue is lower and my tongue is hiding it.
What you can see in the photo, does this appear normal even though they are not the same size?
Thank you for the link but when I paste it in my browser, it just comes up to the google images search page but no actual image....
Thank you !
By that thing on the inside of my cheek has turned somewhat white in color and the protrusion is just slightly bigger. The other day it was I would say 95% gone. Now it's white in color and the protrusion is slightly raised. I went ahead and scheduled an appointment with my ENT but that's not until January 10. I don't know what it could be, it's strange it would be pretty much disappear and then somewhat come back.
You are most Welcome :))
Ok, I promise I will try not to contact so much with my mouth issues and I realize I am obsessing. However, this morning when I woke up I had this strange sensation on the top left side of the inside of my mouth. Almost like a swelling sensation. When I just got home from work, I looked and saw this. I've circled the area that's obviously swollen. I don't think this is a growth, it just looks like the area is swollen. Does cancer usually present in this way?
I was reading....back to the growth on the inside of my cheek (the one that healed and came back two weeks later). Is it possible this is leukoplakia? I read some leukoplakia can appear warty looking (I think this was called verrucous??).
I'm trying, I guess the internet does not help. Too many frightening possibilities. I will look at the website you sent. How about this? Frictional kerratosis
Ok, thank you Doctor.
Hello again. Ok, this is the last of my internet research for now as I think I'm scaring myself very much but I also feel I need to be informed. I found a photo I thought looked similar to my swelling (although mine is smaller). I'm thinking is it possible what I'm seeing in my mouth is not swelling but just asymmetry as compared to the other side? I had to angle my camera a certain way to photo it because when looking directly in my mouth, this circled area in the photo I posted to you previously is not obvious.
Submucosal mass on the right hard palate, near the junction of the hard and soft palates. A painless swelling of the palate is the most common presenting symptom for tumors of the palatal minor salivary glands.