Squamous Cells Papilloma in an HIV-Infected Woman on HAART

Objectives: To describe a mass on the dorsal tongue, in an HIV woman with undergoing antiretroviral therapy (ART). HIV-associated oral lesion spectrum is increasing in the frequency of human papillomavirus-associated oral lesions (HPV-OL), concurring with the introduction of highly active antiretroviral therapy (HAART). A woman who has zidovudine, lamivudine, nevirapine for nine years came with uncomfortable sensation while eating or talking because of the lump in the dorsum tongue since three months ago. Large caries upper right maxillary molar were found in the area near the mass. Complete hematology tests, CD4 counts and viral load were made in preparation for biopsy. Patients agreed to undergo the biopsy and informed consent was made. Excisional biopsy under local anesthesia was done to excise a tumor mass. A mass stored in formaldehyde and histopathological examination is performed.
Methods: Clinical Case, not applicable.
Results: All hematology range are normal, viral load immunoserology HIV undetected. CD4 counts 1.044 cell/uL and CD8 counts 980 cell/uL. A 0.7x0.6x0.3 cm chewy brownish white of mass. The microscopic view revealed mucosa lined with layered squamous epithelium that grows hyperplastically, papillomatosis. The cell’s core is within normal limits. The subepithelium consists of fibrocolagen connective tissue associated with inflammatory cell lymphocytes, plasma cells, and histiocytes. Muscle tissues within normal limits. There is no malignant sign.
Conclusions: Papilloma in this case are benign lesions as a squamous cell papilloma. The concern in HIV patient is important to distinguish from Oral Premalignant Disorder (OPMD). Follow up regularly prevent progression to dysplastic lesion and neoplasia.