Little is said about the odontomas in general surgical literature. These tumors, as they grow, are often regarded as due to necrosed bone or to unerupted teeth, while fibrous odontomas have been often regarded as myeloid sarcomas. No tumor of the jaw, especially in young people, should lead to excision of the jaw until it has been demonstrated that the tumor is not one of the above forms. When diagnosticated as true odontoma its complete removal is all that is necessary.

Papilloma, or Fibro-epithelioma.

—The type of papilloma is this common wart, consisting of a central stem of fibrous tissue and bloodvessels covered by epithelial projections and proliferations. Papillomas are usually sessile and villous.

1. Warts.

[14]—These are sessile papillomas, most common on the skin, often seen on mucous surfaces, and occurring sometimes singly, often in crops. They are exceedingly common about the perineum, where skin and mucous membrane meet, and are regarded as due to the irritation of specific discharges. The papillomas occurring about the genitalia are known as condylomas. The growths in these instances are frequently so luxuriant and proliferative that they assume fungoid shape, and are called mulberry growths. Warts grow slowly or rapidly according to circumstances. Warty growths may attain enormous size and become vascular. Late in life they are frequently the starting points of epithelial ingrowths, and then become true epitheliomas—i. e., cancer. Warty growths sometimes line the buccal cavity and complicate cases of macroglossa. They occur also in the larynx, and when situated near the glottis may cause dyspnea and fatal obstruction to respiration. It is claimed by some that cutaneous warts will disappear with continued small internal dosage of Fowler’s solution. (See [Plate XXI].)

[14] Warts are by many pathologists considered as mere evidences of hypertrophy from persistent irritation. They are here retained among the tumors lest too much violence be done to formerly received notions.

Fig. 86

Papilloma of the bladder.

2. Villous Papillomas.