Hi everyone!

Just stumbled across this page and support group and have found this most helpful. My husband (35) had a growth on his uvulva that multiple doctors had seen over the years and none seemed to be too concerned up until recently. We made an ENT appt because he has been snoring, doctor said he thought the uvulva was a squamous papilloma and was concerned because his right tonsil is larger than his left. They removed the papilloma and it is confirmed that it is a squamous papilloma caused by HPV and the nurse said it did have “rare (which she said meant few) P16 cells. They scheduled an appt with us tomorrow so we can discuss next steps, which we assume based on what the doctor mentioned at the last appt will be a tonsillectomy which my husband is not very keen on, as he thinks his right tonsil has been bigger his whole life (his whole family on his moms side has tonsil issues and many of them have had them removed). I should mention this HPV diagnosis is very strange to us because we have been together since we were 17 and there is no questions of fidelity.

My question is, from what I’m reading the most concerning part of the biopsy is that it’s the “bad” kind of HPV (16), but what I’m having a hard time understanding due to the limited information I’m finding on the internet, is there being some p16 cells a big red flag? Or can that be normal? Are removing the tonsils the only way to confirm tonsil cancer or can they do a biopsy or imaging?

I’m just trying to be prepared for our meeting with the doctor tomorrow and want to know the right questions to ask.

Please post again after your doctor appointment. The biopsy findings are unusual, in that usually there is no ambiguity about cancer or not. p16 is a pretty should marker, but not absolute. Malignant cells once viewed under microscopic exam have distinct changes, the vast majority of the time those changes are definitive evidence of cancer or not.

Squamous papillomas are mostly benign, that’s not a term that describes cancer . So waiting for your next post after your doc visit before commenting further. Hopefully this is another tissue abnormality and not the big c.

Thanks so much for your feedback. The doctor said he doesn’t think it’s probably cancer in his tonsils but could only be sure by doing a tonsillectomy. He told us that in the report the “rare p16” meant they found a few cells but this just means there was hpv16 found. They only did a biopsy of the papilloma which came back benign. If this makes sense. The concern is that his right tonsil is larger than the left. We left the appointment feeling like he didn’t really seem concerned nor could could he really give us many answers as far as next steps besides just getting the tonsils out, so we are getting a second opinion this week.

Here’s what the report says. Maybe you will have a more clear understanding of what this means than we do:
“P16 (rare+) (which they said means few) and HPV 6/11 low risk in situ hybridization negative (HPV 6 and 11 are the most common types found and papillomatosis. Diagnosis: squamous papilloma, rare positive p16 cells”

This sounds like an excellent plan. I would want to know why that tonsil is enlarged. Tonsillectomy is not a big deal to go through, and they will be able to throughly examine it in detail in pathology. The alternative would be fine needle biopsy, puncturing it 6 or more times each in a different area and aspirating some cells from each. It may or may not sample any important area. But when a tonsil or a lymph node is swollen, and that’s occurring on just one side, that isn’t a good sign. If it were me I would opt just to take it off and be sure that nothing gets missed. It’s not like it’s an important vital structure they are removing.

I might be prejudiced because my cancer first presented in a painless tonsil and neck node. They did find the cancer through a FNB, but mine had been like that for a protracted period of time it was all cancerous cells, you couldn’t miss them.

And lots of things that HPV causes are benign. The p16 marker should get consideration because that version of the virus is the most dangerous. His concern or lack of it I’m not as interested in. The pathology report tells the hard science tale, not an opinion. Better to be 100% sure with that second opinion and further biopsy of the swollen tonsil. Best of luck with this, let us know what the outcome is. B