British Journal of Oral and Maxillofacial Surgery (2004) 42, 75—77 CASE REPORT Oral inverted ductal papilloma Tomislav ´ Cabov a , Darko Macan a, * , Spomenka Manojlovi´ c b , Milka Ožegovi´ c b , Jasna Špiˇ cek c , Ivica Lukši´ c a a Department of Maxillofacial and Oral Surgery, University Hospital Dubrava, School of Dental Medicine, School of Medicine, University of Zagreb, Av. G. Šuška 6, 10000 Zagreb, Croatia b Department of Pathology, University Hospital Dubrava, School of Medicine, University of Zagreb, Zagreb, Croatia c Division of Anaesthesiology and Intensive Care, University Hospital for Pulmonary Diseases Jordanovac, Zagreb, Croatia Received 29 January 2003; accepted 14 September 2003 Introduction An oral papilloma is a benign surface tumour that can present anywhere in the oral cavity. Micro- scopically, it is an exophytic, finger-like growth of stratified squamous epithelium on a thin fibrovas- cular core of loose connective tissue. Papillomas with a histological endophytic or inverted pattern of growth are rare. Benign papillary lesions that seem to originate from the salivary ductal sys- tem include intraductal papilloma, inverted ductal papilloma, and sialadenoma papilliferum. Previ- ously, they have been included in the categories of monomorphic adenoma or ductal adenoma. 1 An inverted ductal papilloma of a minor salivary gland was first described in 1982 by White et al. 2 who presented four cases that arose in the floor of the mouth, lower lip, cheek, and soft palate. The term was proposed because the lesion resembles an inverted papilloma of the urinary bladder, nasal cavity, or paranasal sinuses. Similar lesions have also been described in the renal pelvis, lacrimal sac, cervix, and posterior pharyngeal wall. An inverted ductal papilloma is a distinctive lesion with histological features similar to those of the more common inverted papilloma of the nose and *Corresponding author. Tel.: +385-91-4664-075; fax: +385-1-2864-250. E-mail address: darko.macan1@zg.hinet.hr (D. Macan). paranasal sinuses. Although an inverted ductal pa- pilloma shares some histological features with a sinonasal papilloma it can be distinguished on the basis of site. In contrast to an inverted sinonasal papilloma, which arises from the surface epithe- lium and grows endophytically, inverted ductal pa- pilloma arises from the excretory duct of a minor salivary gland. Inverted papillomas of the nasal cavity and paranasal sinuses are associated with squamous cell carcinoma in 10—15% of the cases, 3 while those of minor salivary glands seem to be benign. We know of 29 further cases that have been reported since the report of White et al. 2,4 The age range was from 28 to 77 years with no apparent sex predilec- tion; 15 arose in the lips, 13 on the buccal mucosa, 3 on the palate, and 1 each on the floor of the mouth and oral mucosa. The lesions were typically 1.0—1.5cm nodular swellings with a dilated pore or punctum in the mucosal surface the swelling. 2 Case report A 41-year-old man was referred to the Department of Oral and Maxillofacial Surgery with a painful le- sion on the right buccal mucosa of over 3 years’ du- ration. On oral examination his buccal mucosa was generally healthy. The amount of saliva was nor- mal. There was a localised, freely mobile, nodule 0266-4356/$ — see front matter © 2003 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/S0266-4356(03)00195-5