ORAL HAIRY POLYP IN A TEENAGER: CASE REPORT AND LITERATURE REVIEW

Souza, Vinícius Gonçalves de; Santos, Damilys Joelly Souza; Silva, Thalía Rissa; Macedo, Mathias Rezende; Araújo, Tatiana Santos; Carvalho, Aparecida de Lourdes; Cardoso, Ludimila Paula Vaz; Miranda, Carla Silva Siqueira

doi:10.1590/1984-0462/2020/38/2020143

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Brasil

Revista Paulista de Pediatria

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Brasil

Español English

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CASE REPORT • Rev. paul. pediatr. 38 • 2020 • https://doi.org/10.1590/1984-0462/2020/38/2020143 copy

ORAL HAIRY POLYP IN A TEENAGER: CASE REPORT AND LITERATURE REVIEW

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease.

Case description:

A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient’s mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP.

Comments:

Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.

Keywords:
Dermoid cyst; Oral medicine; Pathology, oral; Pediatrics

Classification	Description
Dermoids (including hairy polyps)	Derived from epidermal and mesodermal germ layers. A fatty tissue is predominant in the matrix.
Teratoids	A poorly differentiated tissue derived from the three germ layers.
Teratomas	More differentiated tissue with trigerminal origin. Organoid structures can be identified histologically.
Epignathic	A parasitic fetus with trigerminal layer and usually incompatible with life

Sociedade de Pediatria de São Paulo R. Maria Figueiredo, 595 - 10o andar, 04002-003 São Paulo - SP - Brasil, Tel./Fax: (11 55) 3284-0308; 3289-9809; 3284-0051 - São Paulo - SP - Brazil
E-mail: rpp@spsp.org.br

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[1] *Corresponding author. E-mail: carlassiqueira@gmail.com (C.S.S. Miranda).

Citation	Gender/age	Location origin	Symptom
Tariq et al.¹²12. Tariq MU, Din NU, Bashir MR. Hairy polyp, a clinicopathologic study of four cases. Head Neck Pathol. 2013;7:232-5. https://doi.org/10.1007/s12105-013-0433-4 https://doi.org/https://doi.org/10.1007/...	Male/12 years	Soft and hard palate	Not reported
Tariq et al.¹²12. Tariq MU, Din NU, Bashir MR. Hairy polyp, a clinicopathologic study of four cases. Head Neck Pathol. 2013;7:232-5. https://doi.org/10.1007/s12105-013-0433-4 https://doi.org/https://doi.org/10.1007/...	Male/1 month	Lower lip	Not reported
Desai et al.²2. Desai A, Kumar N, Wajpayee M, Jatania H. Cleft palate associated with hairy polyp: a case report. Cleft Palate Craniofac J. 2013;50:610-3. https://doi.org/10.1597/11-231 https://doi.org/https://doi.org/10.1597/...	Female/6 months	Hard palate midline, prevalent in the left side	Asymptomatic
Puricelli et al.⁴4. Puricelli E, Barra MB, Hochhegger B, Ponzoni D, Azambuja HV, Morganti MA, et al. Hairy polyp on the dorsum of the tongue-detection and comprehension of its possible dynamics. Head Face Med. 2012;8:19. https://doi.org/10.1186/1746-160X-8-19 https://doi.org/https://doi.org/10.1186/...	Female/3 months	Anterior midline dorsum of tongue, at an almost equal distance between the apex of the tongue and the foramen cecum	Difficulty in swallowing and breathing, associated with cough and vomiting
Yilmaz et al.¹1. Yilmaz M, Ibrahimov M, Ozcan O, Karaman E, Aslan M. Congenital hairy polyp of the soft palate. Int J Pediatr Otorhinolaryngol. 2012;76:5-8. https://doi.org/10.1016/j.ijporl.2011.10.008 https://doi.org/https://doi.org/10.1016/...	Female/2 months	Right side of the soft palate	Difficulty in breathing
Herlin et al.¹¹11. Herlin C, Béziat JL, Koope M, Nimeskern N, Gleizal A. Bilateral dermoid cysts of the upper lip. J Craniofac Surg. 2011;22:2414-5. https://doi.org/10.1097/scs.0b013e318231fe11 https://doi.org/https://doi.org/10.1097/...	Male/47 years	Deep surface of the upper lip, bilateral	Asymptomatic
Gokul et al.¹³13. Gokul S, Hedge V, Hallikeri K. Congenital hairy polyp associated with cleft palate - a rare entity. Int J Clin Pediatr Dent. 2009;2:46-8. https://doi.org/10.5005/jp-journals-10005-1042 https://doi.org/https://doi.org/10.5005/...	Female/8 months	Hard palate, prevalent in the left side	Nasal regurgitation, difficulty in feeding
Erdogan et al.¹⁴14. Erdogan S, Tunali N, Canpolat T, Tuncer R. Hairy polyp of the tongue: a case report. Pediatr Surg Int. 2004;20:881-2. https://doi.org/10.1007/s00383-004-1158-y https://doi.org/https://doi.org/10.1007/...	Female/40 days	Tongue lateral	Not reported
Kiroglu et al.¹⁵15. Kiroglu AF, Kutluhan A, Bayram I, Tuncer O, Sakin F. Reconstruction of a congenital midpalatal hairy polyp. Br J Oral Maxillofac Surg. 2004;42:72-4. https://doi.org/10.1016/S0266-4356(03)00194-3 https://doi.org/https://doi.org/10.1016/...	Female/1 day	Midline of hard palate	Difficulty in feeding
Mahmood et al.¹⁰10. Mahmood S, Moody H. Dermoid, teratoma or choristoma? A rare lesion of the tongue in an adult. Br J Oral Maxillofac Surg. 2003;41:117-9. https://doi.org/10.1016/s0266-4356(02)00300-5 https://doi.org/https://doi.org/10.1016/...	Male/35 years	Midline dorsum of tongue	Discharge of grayish-yellow material

Citation	Histopathologic findings
Tariq et al¹²12. Tariq MU, Din NU, Bashir MR. Hairy polyp, a clinicopathologic study of four cases. Head Neck Pathol. 2013;7:232-5. https://doi.org/10.1007/s12105-013-0433-4 https://doi.org/https://doi.org/10.1007/...	Covered with keratinized pseudostratified squamous epithelium; skin adnexa and seromucinous glands
Tariq et al.¹²12. Tariq MU, Din NU, Bashir MR. Hairy polyp, a clinicopathologic study of four cases. Head Neck Pathol. 2013;7:232-5. https://doi.org/10.1007/s12105-013-0433-4 https://doi.org/https://doi.org/10.1007/...	Covered with keratinized pseudostratified squamous epithelium; skin adnexa, adipose tissue, cartilage and mature bone
Desai et al.²2. Desai A, Kumar N, Wajpayee M, Jatania H. Cleft palate associated with hairy polyp: a case report. Cleft Palate Craniofac J. 2013;50:610-3. https://doi.org/10.1597/11-231 https://doi.org/https://doi.org/10.1597/...	Immature hair follicles; sebaceous and sweat glands in the fibrous connective tissue
Puricelli et al.⁴4. Puricelli E, Barra MB, Hochhegger B, Ponzoni D, Azambuja HV, Morganti MA, et al. Hairy polyp on the dorsum of the tongue-detection and comprehension of its possible dynamics. Head Face Med. 2012;8:19. https://doi.org/10.1186/1746-160X-8-19 https://doi.org/https://doi.org/10.1186/...	Keratinized squamous epithelium containing connective and adipose tissue, smooth and striated muscle, and salivary glands
Yilmaz et al.¹1. Yilmaz M, Ibrahimov M, Ozcan O, Karaman E, Aslan M. Congenital hairy polyp of the soft palate. Int J Pediatr Otorhinolaryngol. 2012;76:5-8. https://doi.org/10.1016/j.ijporl.2011.10.008 https://doi.org/https://doi.org/10.1016/...	Fibrous and adipose tissue, seromucinous glands, hair follicles, eccrine sebaceous and sweat glands, keratinized stratified squamous epithelium
Herlin et al.¹¹11. Herlin C, Béziat JL, Koope M, Nimeskern N, Gleizal A. Bilateral dermoid cysts of the upper lip. J Craniofac Surg. 2011;22:2414-5. https://doi.org/10.1097/scs.0b013e318231fe11 https://doi.org/https://doi.org/10.1097/...	Aspect compatible with dermoid cyst (dermal and epidermal tissues)
Gokul et al.¹³13. Gokul S, Hedge V, Hallikeri K. Congenital hairy polyp associated with cleft palate - a rare entity. Int J Clin Pediatr Dent. 2009;2:46-8. https://doi.org/10.5005/jp-journals-10005-1042 https://doi.org/https://doi.org/10.5005/...	Parakeratinized squamous epithelium, hair follicles, sebaceous and sweat glands in fibrous stroma; adipose tissue
Erdogan et al.¹⁴14. Erdogan S, Tunali N, Canpolat T, Tuncer R. Hairy polyp of the tongue: a case report. Pediatr Surg Int. 2004;20:881-2. https://doi.org/10.1007/s00383-004-1158-y https://doi.org/https://doi.org/10.1007/...	Stratified squamous epithelium, adipose tissue, muscle, skin adnexa, minor salivary glands, and cartilage
Kiroglu et al.¹⁵15. Kiroglu AF, Kutluhan A, Bayram I, Tuncer O, Sakin F. Reconstruction of a congenital midpalatal hairy polyp. Br J Oral Maxillofac Surg. 2004;42:72-4. https://doi.org/10.1016/S0266-4356(03)00194-3 https://doi.org/https://doi.org/10.1016/...	Keratinized squamous epithelium, pilosebaceous glands, adipose and connective tissue
Mahmood et al.¹⁰10. Mahmood S, Moody H. Dermoid, teratoma or choristoma? A rare lesion of the tongue in an adult. Br J Oral Maxillofac Surg. 2003;41:117-9. https://doi.org/10.1016/s0266-4356(02)00300-5 https://doi.org/https://doi.org/10.1016/...	Stratified squamous epithelium, sebaceous glands, apocrine glands, and cartilage.