Middle ear squamous papilloma: A report of four cases analyzed by HPV and EBV in situ hybridization

Zhou,Han; Chen,Zhibin; Zhang,Weiming; Xing,Guangqian

doi:10.3892/ol.2013.1675

Middle ear squamous papilloma: A report of four cases analyzed by HPV and EBV in situ hybridization

Authors:
- Han Zhou
- Zhibin Chen
- Weiming Zhang
- Guangqian Xing
View Affiliations

Affiliations: Department of Otolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China, Department of Pathology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
Published online on: November 11, 2013 https://doi.org/10.3892/ol.2013.1675
Pages: 41-46

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Squamous papilloma involving the middle ear as a primary lesion is an extremely rare occurrence. The aims of the present study were to investigate the presence of human papilloma virus (HPV) and Epstein‑Barr virus (EBV) infections in primary middle ear squamous papilloma and to describe the clinical and pathological features of the disease along with therapeutic strategies. A retrospective review was conducted of four patients with clinical and pathological diagnoses of middle ear squamous papilloma. In situ hybridization (ISH) for a wide range of HPV DNA subtypes and EBV‑encoded RNA was performed in the tissue samples obtained from these patients. Only two cases of primary squamous papilloma in the middle ear have been previously reported in the English literature. These papillomas developed in males of ~60‑years of age and otorrhea was the most frequent complaint. Premalignant changes were observed in two of the present cases and ISH of HPV and EBV was negative in all four cases. The results of the present study indicated that chronic inflammatory stimulation, not HPV and EBV infection, is involved in the occurrence of middle ear squamous papilloma and its malignant transformation. Radical surgery and long‑term postoperative follow‑up are recommended due to its malignant and recurrent potential. Further genetic investigations with additional new cases are required to clarify the pathogenesis of squamous papilloma involving the middle ear.

View Figures

View References

1	Xia MY, Zhu WY, Lu JY, Lu Q and Chen L: Ultrastructure and human papillomavirus DNA in papillomatosis of external auditory canal. Int J Dermatol. 35:337–339. 1996. View Article : Google Scholar : PubMed/NCBI
2	Cahali S, da Silva FB, Machado MC, da Silva DA, Reforeme OM and Cahali MB: Middle ear squamous papilloma: report of a case and literature review. Braz J Otorhinolaryngol. 71:396–398. 2005.(In Portuguese).
3	Gaffey MJ, Frierson HF, Weiss LM, Barber CM, Baber GB and Stoler MH: Human papillomavirus and Epstein-Barr virus in sinonasal Schneiderian papillomas. An in situ hybridization and polymerase chain reaction study. Am J Clin Pathol. 106:475–482. 1996.
4	Pou AM, Weems J, Deskin RW, Nason R and Payne DA: Molecular characterization of mutations in patients with benign and aggressive recurrent respiratory papillomatosis: a preliminary study. Ann Otol Rhinol Laryngol. 113:180–186. 2004. View Article : Google Scholar
5	Carneiro TE, Marinho SA, Verli FD, Mesquita AT, Lima NL and Miranda JL: Oral squamous papilloma: clinical, histologic and immunohistochemical analyses. J Oral Sci. 51:367–372. 2009. View Article : Google Scholar : PubMed/NCBI
6	Oliveira LR, Ribeiro-Silva A, Ramalho LN, Simões AL and Zucoloto S: HPV infection in Brazilian oral squamous cell carcinomapatients and its correlation with clinicopathological outcomes. Mol Med Rep. 1:123–129. 2008.
7	Sham CL, To KF, Chan PK, Lee DL, Tong MC and van Hasselt CA: Prevalence of human papillomavirus, Epstein-Barr virus, p21 and p53 expression in sinonasal inverted papilloma, nasal polyp, and hypertrophied turbinate in Hong Kong patients. Head Neck. 34:520–533. 2012. View Article : Google Scholar
8	de Santos Torres SAM, Castro TW, Bento RF and Lessa HA: Middle ear papilloma. Braz J Otorhinolaryngol. 73:4312007.
9	Zhou H, Chen Z, Li H and Xing G: Primary temporal inverted papilloma with premalignant change. J Laryngol Otol. 125:206–209. 2011. View Article : Google Scholar : PubMed/NCBI
10	de Filippis C, Marioni G, Tregnaghi A, Marino F, Gaio E and Staffieri A: Primary inverted papilloma of the middle ear and mastoid. Otol Neurotol. 23:555–559. 2002.PubMed/NCBI
11	Chelimo C, Wouldes TA, Cameron LD and Elwood JM: Risk factors for and prevention of human papillomaviruses (HPV), genital warts and cervical cancer. J Infect. 66:207–217. 2012. View Article : Google Scholar : PubMed/NCBI
12	Derkay CS and Wiatrak B: Recurrent respiratory papillomatosis: a review. Laryngoscope. 118:1236–1247. 2008. View Article : Google Scholar : PubMed/NCBI
13	Tsai ST, Li C, Jin YT, Chao WY and Su IJ: High prevalence of human papillomavirus types 16 and 18 in middle-ear carcinomas. Int J Cancer. 71:208–212. 1997. View Article : Google Scholar : PubMed/NCBI
14	Speel EJ, Hopman AH and Komminoth P: Amplification methods to increase the sensitivity of in situ hybridization: play card(s). J Histochem Cytochem. 47:281–288. 1999. View Article : Google Scholar : PubMed/NCBI
15	Syrjänen S, Syrjänen K, Mäntyjärvi R, Collan Y and Kärjä J: Human papillomavirus DNA in squamous cell carcinomas of the larynx demonstrated by in situ DNA hybridization. ORL J Otorhinolaryngol Relat Spec. 49:175–186. 1987.PubMed/NCBI
16	Wenig BM: Schneiderian-type mucosal papillomas of the middle ear and mastoid. Ann Otol Rhinol Laryngol. 105:226–233. 1996. View Article : Google Scholar : PubMed/NCBI
17	Roberts WH, Dinges DL and Hanly MG: Inverted papilloma of the middle ear. Ann Otol Rhinol Laryngol. 102:890–892. 1993. View Article : Google Scholar : PubMed/NCBI
18	Marioni G, Altavilla G, Busatto G, Blandamura S, De Filippis C and Staffieri A: Detection of human papillomavirus in temporal bone inverted papilloma by polymerase chain reaction. Acta Otolaryngol. 123:367–371. 2003. View Article : Google Scholar
19	de Koning MN, Khoe LV, Eekhof JA, et al: Lesional HPV types of cutaneous warts can be reliably identified by surface swabs. J Clin Virol. 52:84–87. 2011.
20	Tseng CJ, Pao CC, Tseng LH, et al: Lymphoepithelioma-like carcinoma of the uterine cervix: association with Epstein-Barr virus and human papillomavirus. Cancer. 80:91–97. 1997. View Article : Google Scholar : PubMed/NCBI
21	Mizugaki Y, Sugawara Y, Shinozaki F and Takada K: Detection of Epstein-Barr virus in oral papilloma. Jpn J Cancer Res. 89:604–607. 1998. View Article : Google Scholar : PubMed/NCBI
22	Tsai ST, Jin YT, Mann RB and Ambinder RF: Epstein-Barr virus detection in nasopharyngeal tissues of patients with suspected nasopharyngeal carcinoma. Cancer. 82:1449–1453. 1998. View Article : Google Scholar
23	Suarez PA, Adler-Storthz K, Luna MA, El-Naggar AK, Abdul-Karim FW and Batsakis JG: Papillary squamous cell carcinomas of the upper aerodigestive tract: a clinicopathologic and molecular study. Head Neck. 22:360–368. 2000. View Article : Google Scholar : PubMed/NCBI
24	Russell JO, Hoschar AP and Scharpf J: Papillary squamous cell carcinoma of the head and neck: a clinicopathologic series. Am J Otolaryngol. 32:557–563. 2011. View Article : Google Scholar : PubMed/NCBI
25	Batsakis JG and Suarez P: Schneiderian papillomas and carcinomas: a review. Adv Anat Pathol. 8:53–64. 2001. View Article : Google Scholar : PubMed/NCBI