Conjunctival Exophytic Schneiderian-type Papillomas: A Rare Occurrence

Area of Science:

• Ophthalmology
• Pathology
• Oncology

Background:

• Conjunctival papillomas typically present as exophytic growths with filiform fronds.
• Inverted (Schneiderian) papillomas are rare on the conjunctiva, with only 15 cases previously reported.
• Sinonasal papillomas, particularly the endophytic type, have a low rate of malignant transformation.

Purpose of the Study:

• To describe two cases of exophytic conjunctival papillomas exhibiting morphology similar to sinonasal or Schneiderian-type papillomas.
• To investigate the clinicopathological and etiological features of these rare conjunctival tumors.

Main Methods:

• Case report of two patients with exophytic conjunctival papillomas.
• Histopathological examination including immunohistochemistry for cytokeratin 7, p16, and p53.
• Human papillomavirus (HPV) detection to identify the driving oncogenic factor.

Main Results:

• Both cases presented as pink, sessile acquired growths in postmenopausal women.
• Histopathology revealed nonkeratinizing squamous epithelium, goblet cells, intraepithelial mucinous cysts, and microabscesses.
• Immunohistochemistry showed cytokeratin 7 reactivity and wild-type p16/p53 staining, consistent with common conjunctival papillomas; both were HPV-driven.

Conclusions:

• Exophytic conjunctival papillomas can rarely mimic the morphology of sinonasal (Schneiderian) papillomas.
• These rare conjunctival tumors are associated with low-risk human papillomavirus.
• Further research is warranted to understand the potential implications and management of this specific conjunctival papilloma subtype.