Iwamuro M, Tanaka T, Hamada K, Kono Y, Kawano S, Kawahara Y, Otsuka M. Endoscopic features of oral and pharyngolaryngeal papillomas and their role in distinguishing squamous cell carcinoma. World J Gastrointest Endosc 2025; 17(12): 110594 [DOI: 10.4253/wjge.v17.i12.110594]
Corresponding Author of This Article
Masaya Iwamuro, MD, PhD, Assistant Professor, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 16, 2025 (publication date) through Dec 19, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Iwamuro M, Tanaka T, Hamada K, Kono Y, Kawano S, Kawahara Y, Otsuka M. Endoscopic features of oral and pharyngolaryngeal papillomas and their role in distinguishing squamous cell carcinoma. World J Gastrointest Endosc 2025; 17(12): 110594 [DOI: 10.4253/wjge.v17.i12.110594]
Masaya Iwamuro, Kenta Hamada, Yoshiyasu Kono, Seiji Kawano, Motoyuki Otsuka, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Takehiro Tanaka, Department of Pathology, Okayama University Hospital, Okayama 700-8558, Japan
Yoshiro Kawahara, Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Iwamuro M, Hamada K, Kono Y, Kawano S, Kawahara Y, and Otsuka M contributed to data acquisition; Iwamuro M, Tanaka T, Kawahara Y, and Kono Y were involved in data analysis; Iwamuro M designed this study; Tanaka T contributed to the pathological diagnosis. All the authors have read and approved the final version of this manuscript.
Institutional review board statement: This retrospective study was performed in accordance with the principles of the Declaration of Helsinki and approved by the Ethics Committee of our hospital (Number 2310-007).
Informed consent statement: The requirement for written informed consent was waived by the Ethics Committee of our hospital due to the retrospective nature of the study and the use of anonymous clinical data for analysis.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Masaya Iwamuro, MD, PhD, Assistant Professor, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Received: June 11, 2025 Revised: August 26, 2025 Accepted: October 29, 2025 Published online: December 16, 2025 Processing time: 189 Days and 14.9 Hours
Abstract
BACKGROUND
Oral and pharyngolaryngeal papillomas are occasionally detected during esophagogastroduodenoscopy. However, their endoscopic features have not been sufficiently investigated.
AIM
To distinguish oral and pharyngolaryngeal papillomas from elevated squamous carcinomas, this study examined their endoscopic features.
METHODS
Forty-seven patients with oral or pharyngeal papilloma participated in this study. The endoscopic characteristics of papillomas were identified by focusing on narrowband and blue laser imaging representations.
RESULTS
Papillomas were classified into three patterns based on their endoscopic features: Salmon roe-like polyps, polyps without capillary transparency, and pinecone-like polyps, with salmon roe-like polyps most prevalent (48.9%). We subsequently analyzed features differentiating papillomas and squamous cell carcinomas in the same region and found that squamous cell carcinomas exhibited at least one of the following three features: Uneven or absent lobulated structure, irregular morphology of capillaries, and coexistence of flat lesions. In contrast, papillomas displayed a uniform lobulated structure, homogeneous or non-visible capillaries, and an absence of flat components. When any of these characteristics were present, two endoscopic specialists evaluated the lesions for the diagnosis of squamous cell carcinoma, with sensitivities of 100% and 97.6% and specificities of 68.9% and 93.3%.
CONCLUSION
Understanding distinct endoscopic patterns of oropharyngeal papillomas and squamous cell carcinomas provides valuable guidance to endoscopists performing esophagogastroduodenoscopy.
Core Tip: This retrospective study highlighted the endoscopic features of oral and pharyngolaryngeal papillomas and identified three distinct morphological patterns: Salmon roe-like, polyps without capillary transparency, and pinecone-like. By contrasting these features with those of squamous cell carcinomas, namely, uneven lobulated structures, irregular capillaries, and flat lesion components, this study provides practical guidance for distinguishing these lesions during esophagogastroduodenoscopy. Our findings may reduce unnecessary biopsies and improve diagnostic accuracy, offering endoscopists valuable insights into oropharyngeal region evaluations. To our knowledge, this is the first detailed analysis of the endoscopic patterns of papillomas in these regions.
