An adult case of multiple squamous papillomas of the trachea associated with human papilloma virus type 6

Department of Respiratory Medicine, Tokyo Teishin Hospital.
Internal Medicine (Impact Factor: 0.97). 02/2008; 47(17):1535-8. DOI: 10.2169/internalmedicine.47.1239
Source: PubMed

ABSTRACT A 72-year-old woman with primary biliary cirrhosis complained of dry cough and wheezing. Chest computed tomography showed a tumor arising from the posterior wall of the trachea. Bronchoscopic examination revealed that the tumor was cauliflower-like, with two small polypoid tumors. They were diagnosed as multiple squamous papillomas. The main tumor was recurrent and removed by repeated microwave coagulation therapy (MCT) through bronchoscopy, whereas the two polypoid tumors were likely to disappear spontaneously. Human papilloma virus (HPV) type 6 DNA was detected in the tumor by polymerase chain reaction (PCR) amplification, suggesting that this virus was the cause of her papillomas.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent respiratory papillomatosis is a viral induced disease characterised by exophytic epithelial lesions affecting the larynx. The problem with its treatment is the high recurrence of papilloma growth after surgical removal. The aim of our review is to analyse the actual use of cidofovir, an agent used in adjuvant therapy. We have reviewed 6 manuscripts that included a total of 118 patients. The parameters taken into account were: concentration of infiltrated cidofovir (mg/ml), therapeutic response, relapse-free time (months), side effects, genotypes (HPV-6/11/18) and evolution of dysplasia. Cidofovir was injected at concentrations from 2.5 to 15 mg/ml, therapeutic response was from 56.25% to 82.3% and relapse-free time was from 10.05 to 49 months. There were 2 cases of dysplasia during therapy. Ten patients had been infected by HPV-6, 4 patients by HPV-11 and 10 patients by HPV-6 and HPV-11. The purposes of our review include the following: to stress that the juvenile form is more aggressive than other forms, to demonstrate than the drug has good adjuvant action although it does not significantly change the final response to the disease, to show that side effects are modest and, finally, to disprove the hypothesis that cidofovir may promote evolution towards dysplasia. In conclusion, combination of surgical removal and injection of cidofovir is associated with good response in recurrent respiratory papillomatosis.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent respiratory papillomatosis (RRP) primarily caused by human papillomas virus is a rare and benign neoplasm, primarily involving the epithelium mucosae of the respiratory tract. RRP may occur anywhere in the respiratory tract with a predilection to the laryngeal area and may potentially threaten life. Because of the absence of specific clinical manifestations, the diagnosis of this disease is easily delayed. The high awareness of RRP and performing endoscopy as soon as possible in suspected patients are the prerequisites for early diagnosis. Surgical removal on endoscope is still a fundamental treatment. Adjuvant treatment is required only in some patients. Because of the potential of malignant transformation and recurrence, careful follow-up for RRP is required for early detection and treatment.
    European Journal of Clinical Microbiology 09/2010; 29(9):1051-4. DOI:10.1007/s10096-010-0963-6 · 2.54 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent respiratory papillomatosis (RRP) is an infrequent benign neoplasm commonly involving the upper respiratory tract with laryngeal predilection. The diagnosis and treatment of this disease are challenging due to its nonspecific clinical presentations and recurrent nature. We report here a rare juvenile case of RRP arising in the trachea without laryngeal lesions. Our experiences indicate that a high awareness of RRP and proper consideration in the right clinical context are prerequisites for early diagnosis, and a combination of multiple treatment modalities should be considered as a feasible treatment regimen.
    Internal Medicine 01/2010; 49(15):1649-51. DOI:10.2169/internalmedicine.49.3443 · 0.97 Impact Factor