A two-year-old male castrated mixed breed dog was presented to the Cornell University Hospital for Animals (CUHA) Dentistry and Oral Surgery Service for a one-year history of papillomatosis. The nodules were originally on his toes; they resolved in 3-5 months without treatment, save for one area that required cryotherapy. The patient developed nodules around his mouth 7 months prior to presentation. These nodules had been increasing in severity despite two courses of azithromycin and 4 doses of autogenous vaccine. On physical examination the patient had multifocal, exophytic, papillomatosis masses on the lips, tongue, oral mucosa, and gingiva. There was a large mass with covering papilloma associated with the right maxilla and distorting the facial symmetry. The mass surrounded the right maxillary P4 which was buccoverted and mobile. Differential diagnoses for the persistent papillomatosis include immunodeficiency and underlying disease. Differential diagnoses for the mass include severe periodontitis secondary to papillomatosis or malignancy with bone invasion.

Serum electrophoresis was performed to screen for immunodeficiency, which demonstrated a normal serum total protein concentration with mild increase in gamma globulins. Head computed tomography (CT) (with and without contrast) and incisional biopsies were performed for further evaluation of the lesions. The CT demonstrated a severe, locally extensive, oral soft tissue mass with lysis of the right maxilla and right mandible. Histopathology of the oral biopsies revealed numerous viral-induced exophytic and inverted papillomas with evidence of multifocal neoplastic transformation to squamous cell carcinoma. The patient was referred to Cornell’s Oncology Service. This seminar will review the pathogenesis and treatment of papillomatosis as well as the etiology of the transformation to squamous cell carcinoma.