title: Conjunctival papilloma: features and outcomes based on age at initial examination.
abstract: OBJECTIVE
  Conjunctival papilloma is a benign epithelial tumor occurring in both children and adults with varying clinical features and outcomes. In this article, we describe our experience regarding the difference in the clinical features and outcomes of conjunctival papilloma based on age at initial examination.
  
  
  OBJECTIVE
  To evaluate the clinical features, treatment, and outcomes in patients with conjunctival papilloma based on age at initial examination.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
  
  
  METHODS
  Ten children and adolescents (aged ≤20 years) and 63 adults (aged >20 years) with conjunctival papilloma.
  
  
  METHODS
  Excisional biopsy, cryotherapy, oral cimetidine, topical or injection interferon alfa-2b, and photodynamic therapy.
  
  
  METHODS
  Tumor response.
  
  
  RESULTS
  A comparison of conjunctival papillomas between age groups revealed significant differences in the mean number of tumors per eye (children and adolescents vs adults, 2 vs 1; P = .05), tumor basal dimension (8 vs 6 mm; P = .05), and associated feeder vessels (20% vs 47%; P = .05). Primary treatment included sole treatment with oral cimetidine (15% vs 5%), topical interferon alfa-2b (0% vs 1%), cryotherapy (0% vs 3%), photodynamic therapy (0% vs 1%), excisional biopsy and cryotherapy (38% vs 65%), excisional biopsy and cryotherapy with adjuvant oral cimetidine (8% vs 9%), and excisional biopsy and cryotherapy with adjuvant topical or injection interferon alfa-2b (38% vs 15%). Significant differences in age groups in treatment outcome during the follow-up period (mean, 24 vs 38 months) included complete regression with single treatment (38% vs 95%; P < .01) and tumor recurrence (15% vs 1%; P = .05).
  
  
  CONCLUSIONS
  Conjunctival papillomas are larger and more likely to be multiple in children and adolescents than in adults. Excisional biopsy and cryotherapy with or without adjuvant oral cimetidine and/or topical interferon alfa-2b provide satisfactory tumor control. Papilloma recurrence is more common in children and adolescents than in adults.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Swathi
authors.initials: S
authors.lastname: Kaliki
authors.forename: Sruthi
authors.initials: S
authors.lastname: Arepalli
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Kendra
authors.initials: K
authors.lastname: Klein
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.forename: Eralda
authors.initials: E
authors.lastname: Hysenj
authors.forename: Sara E
authors.initials: SE
authors.lastname: Lally
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002927:Cimetidine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003230:Conjunctival Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D017679:Cryotherapy; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D015994:Incidence; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D010212:Papilloma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D010778:Photochemotherapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004791:Enzyme Inhibitors; D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D002927:Cimetidine