Esophageal Squamous Papilloma in the Pediatric Population

N Malhotra et al JPGN Reports 2022; doi: 10.1097/PG9.0000000000000178. Open Access: Esophageal Squamous Papilloma in the Pediatric Population

  • This is a case report of 4 cases of esophageal squamous papilloma (ESP); Three out of the 4 cases of ESP identified at our institution were positive for HPV in situ hybridization.
  • “Chronic mucosal irritation due to GERD or HPV is thought to be the most common cause of ESP…a recent study failed to identify a relationship between the prevalence of HPV and the occurrence of ESP in pediatric patients”
  • “Small esophageal lesions can be managed by excisional biopsy; however, conservative management is advised when the disease is extensive to avoid mucosal scarring and stenosis…Acid suppression may decrease ongoing inflammation.”
  • “Vaccinating children with active HPV infection could theoretically increase the immune response and potentially aid in clearance of lesions caused by the disease.”

Related blog post: Esophageal Squamous Papilloma in Children Are Rare

Esophageal Squamous Papilloma in Children Are Rare

AM Tou, AO Al-Nimr. JPGN 2021; 72: 690-692. Esophageal Squamous Papilloma in Children: A Single-center Case

Key findings:

  • Of 12,459 children who had an EGD (2000-2014), 10 children (0.08%) were identified with an esophageal squamous papillom (ESP)a on biopsy. Ages ranged from 2 to 17 years.
  • All samples tested for HPV via FISH analysis were negative

The authors note that “surveillance is …largely considered unnecessary.”

My take: ESP is a rare benign lesion found incidentally in the pediatric population.

Image online from N Alkhouri et al. JPGN 46(3):237, March 2008.
Endoscopic Appearance of an Esophageal Squamous Papilloma in a Pediatric Patient