[Question #7682] On oral warts and contagion

54 months ago

Hi,

When I was 16, in 2012, before I was even sexually active, I found 2 papillomas in my tonsillar area. (one tonsil, one on the uvula.) The tonsillar one was removed by an ENT (he missed the uvular one) in 2013. He also used a scope to check my voicebox for papillomas, and it was apparently clear. A year later. In 2014 (about 2 years from finding the first one) I found a third on my other tonsil.

No doctor ever said the word 'HPV' to me, but by googling it I put the pieces together. I never got to speak to the ENT again and my GPs don't know a lot about HPV or papillomas. I am very scared that, some 8 years on, I could still be contagious and I am very scared of developing new papillomas. I have a hard time finding consistent info online on if I am still contagious, if I should be abstaining from being with other people, etc, which is why I have come here to ask some experts. Nobody I have been sexually active with (only 2 people) have ever developed any papillomas. My pap smears have been consistently clean, and I have never developed genital warts.

I have not found other oral papillomas since 2014, but I am still scared and it a huge source of health anxiety for me. I removed the uvular one and the other tonsil one myself during particularly extreme panic attacks. Is still being contagious a valid fear, or could my body have cleared the virus by now? Thank you for your time.

Edward W. Hook M.D.

54 months ago

Welcome to the Forum. Thanks for your question. I'll be glad to offer some thoughts however your situation may benefit most from consultation with and Ear, Nose, and Throat (ENT) specialist. Papilloma's are growths of epithelial cells. Most, but not all are associated with HPV infection. Many HPV infections are transmitted through sexual contact but this is not the case for all papillomas. Your Oral papillomas may or may not have been associated with HPV infection and this is something, even years after the removal, that may be able to be investigated by careful evaluation of the tissue that was removed (pathologists often keep excised tissue specimens for years).

I would challenge your assumption that you are "contagious" until you have been evaluated thoroughly. You d not know tha the papillomas that have been found were HPV-related, nor that there is an active problem present at this time

My sincere advice in this unusual situation is to seek evaluation by an ENT specialist who can thoroughly examine you. He/she may have further advice. In the interim, given your concern about HPV I would add as an unrelated recommendation that you be sure to get the HPV vaccine if you have not already. EWH

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54 months ago

Hi,

I got 2 doses of the quadrivalent as a kid, got one dose of the 9-valent at 22 or so. So, I have gotten the vax and had at least two before these papillomas showed up.

The way it works in Canada is a bit odd - I will have to see my GP and she can refer me to an ENT if she thinks there is an active problem. It may be hard to get a hold of the tissue sample, since I've moved regions since then and my new GP had an issue getting hold of some of my medical records.

All 3 papillomas were pedunculated.

Given the above, and that I may be unable to see an ENT, my question is:

1) If it WAS HPV, is it likely to have cleared by now?

2) If it was NOT HPV - I cannot find any conditions online which could cause oral papillomas outside of RRP (which I have no symptoms for) and a few genetic cancer-predisposing syndromes which I do not seem to have either. (no history of cancer in my family) Is this something which it's recommended that I pursue aggressively, in case it was related to something life threatening?

Thank you for any insight you may have

Edward W. Hook M.D.

54 months ago

Thanks for the information on your vaccination status. Congratulations on being thoroughly vaccinated. It will serve you well going forward.

Dr. Handsfield and I discussed your questions off line. He is in agreement with my assessment above. The topic of pedunculated oral lesions is one that neither of us is expert in and, given your concerns, we encourage you to press forward to see an ENT who can provide more information. At the same time, we both are doubtful that the lesion that was removed nearly 10 years ago was a wart or even HPV related. We believe that the lesions you have noted may be more analogous to non-HPV skin tag which are relatively common. If it was HPV related, we suspect it was caused by one of the many (more than 100) types of HPV which is not associated with sexual transmission. Further, we believe that, irrespective of the origin of your lesions, that you are not likely to transmit them through kissing or oral sex.

I hope that this perspective is helpful. EWH

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54 months ago

Dr. Hook, thank you for your response and your advice. It is of great comfort to me that it is likely not transmissible, I spent many years feeling confused and worried that I would pass it on. I will speak to my GP and see what she thinks about seeing an ENT, or if she can get a copy of the pathology report for the initial lesion.

Thank you for your time and have a great day.

Edward W. Hook M.D.

54 months ago

I'm pleased my comments were helpful. EWH
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