PAPILLARY SQUAMOUS NEOPLASMS OF THE HEAD AND NECK

Papillary squamous neoplasms of the upper respiratory tract are rare v ariants of squamous cell carcinoma and are related temporally to proli ferative verrucous leukoplakia. Fifty-two cases of papillary squamous neoplasms were selected from 2366 cases of squamous cell carcinoma. Th is is the first study to characterize the biological behavior of papil lary squamous neoplasms. Papillary squamous neoplasms exhibit two dist inct, yet sometimes overlapping, histologic patterns including an exop hytic papillary and an inverting verrucous morphologic appearance. A h igh rate of synchronous or metachronous lesions were found, especially with the inverting-type of papillary squamous neoplasm. Stage T3 and T4 lesions had a high rate of neck metastasis. Early surgical interven tion and close long-term follow-up is mandatory.