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An aggresive and invasive growth of juvenile papillomas involving the total respiratory tract

Published online by Cambridge University Press:  29 June 2007

Bodil Laub Petersen ,
Christian Buchwald ,
Jan Gerstoft ,
Poul Bretlau  and
Henning Lindeberg
Bodil Laub Petersen*
Affiliation:
Department of Pathology, Rigshospitalet, Denmark
Christian Buchwald
Affiliation:
Department of Otolaryngology, Rigshospitalet, Denmark
Jan Gerstoft
Affiliation:
Department of Microbiology, Rigshospitalet, Denmark
Poul Bretlau
Affiliation:
Department of Otolaryngology, Rigshospitalet, Denmark
Henning Lindeberg
Affiliation:
Department of Oral Pathology Lab, Royal Dental College, Aarhus, Denmark
*
Address for correspondence: Bodil Laub Petersen, Department of Pathology, Rigshospitalet, Copenhagen, Denmark. Fax: 0045-35456380 e-mail: RH02875@RH.DK
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Abstract

A malignant course of juvenile laryngeal papillomatosis has rarely been reported. In the present case the patient had had laryngeal papillomas since the age of three years. The papillomas gradually spread to the entire respiratory system, and during 30 years the patient was operated on more than 80 times. At present an invasive tumour spreading from the tongue into the parapharyngeal space, extending to the cranial base, has been demonstrated by magnetic resonance imaging (MRI).

Intralesional therapy with Cidofovir, a promising antiviral drug against human papillomavirus (HPV) infection, was started with some clinical effect, although only on the superficial tumour growth. Histology of removed tumour tissue has demonstrated a mixture of exophytic and inverted growth pattern, and has mainly been interpreted as benign, in spite of a focally high mitotic index and an intermittent lack of maturation in the epithelium. In the most recent biopsies a verrucous carcinoma has been diagnosed. Expression of p53 was noted to increase in papillomas with time. All samples have been shown to harbour HPV 11, but no other HPV types.

Keywords

PapillomaLaryngeal diseasesPapilloma virusCarcinomaImmunochemistry
Type
Pathology in Focus
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 11 , November 1998 , pp. 1101 - 1104
Copyright
Copyright © JLO (1984) Limited 1998

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