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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*
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: [email protected]

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.

Type
Pathology in Focus
Copyright
Copyright © JLO (1984) Limited 1998

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References

Abramson, A. L., Steinberg, B. M., Winkler, B. (1987) Laryngeal papillomatosis: clinical, histopathological and molecular studies. Laryngoscope 97: 678685.CrossRefGoogle ScholarPubMed
Brandsma, J., Steinberg, B. M., Abramson, A. L., Winkler, B. (1986) Presence of human papilloma virus type 16 related sequences in verrucous carcinoma of the larynx. Cancer Research 46: 21852188.Google Scholar
Buchwald, C., Franzmann, M.-B., Jacobsen, G. K., Lindeberg, H. (1993) The presence of human papilloma virus (HPV) in sinonasal papillomas, demonstrated by polymerase chain reaction with consensus primers. Human Pathology 24: 13541356.CrossRefGoogle Scholar
Buchwald, C., Franzmann, M.-B., Jacobsen, G. K., Lindeberg, H. (1995) Human papillomavirus (HPV) in sinonasal papillomas: A study of 78 cases using in situ hybridization and polymerase chain reaction. Laryngoscope 105: 6671.CrossRefGoogle ScholarPubMed
Cohen, S. R., Geller, K. A., Seltzer, S., Thompson, J. W. (1980) Papilloma of the larynx and tracheobronchial tree in children. A retrospective study. Annals of Otology, Rhinology and Laryngology 89: 497503.CrossRefGoogle ScholarPubMed
Gayliss, B., Hayden, R. E. (1991) Recurrent respiratory papillomatosis: Progression to invasion and malignancy. American Journal of Otolaryngology 12: 104112.CrossRefGoogle Scholar
Guillou, L., Sahli, R., Chaubert, P., Monnier, P., Cuttat, J. F., Costa, J. (1991) Squamous cell carcinoma of the lung in a non-smoking, non-irradiated patient with juvenile laryngotracheal papillomatosis. American Journal of Surgical Pathology 15: 891898.CrossRefGoogle Scholar
Hørding, U. (1994) Human papillomavirus in epithelial neoplasia of the vulva and the uterine cervix (Thesis). Copenhagen, Laegeforeningens forlag.Google Scholar
Busman, A. M. de Roda, Walboomers, J. M. M., Van den Brule, A. J. C., Meijer, C. J., Snijders, P. J. F. (1995) The use of general primers GP5 and GP6 elongated at their 3′ ends with adjacent highly conserved sequences improves human papilloma virus detection by PCR. Journal of General Virology 76: 10571062.Google Scholar
Lindeberg, H., Elbrønd, O. (1990) Laryngeal papillomas: The epidemiology in a Danish subpopulation 1965–1984. Clinical Otolaryngology 15: 125131.CrossRefGoogle Scholar
Lindeberg, H., Elbrønd, O. (1991) Malignant tumours in patients with a history of multiple laryngeal papillomas: The significance of irradiation. Clinical Otolaryngology 16: 149151.CrossRefGoogle ScholarPubMed
Lindeberg, H., Kroghdahl, A. (1997) Laryngeal dysplasia and the human papillomavirus. Clinical Otolaryngology 22: 382386.CrossRefGoogle ScholarPubMed
Lindeberg, H., Syrjanen, S., Karja, J., Syrjanen, K. (1989) Human papilloma virus type 11 DNA in squamous cell carcinomas and preexisting multiple laryngeal papillomas. Ada Otolaryngologica (Stockh) 107: 141149.CrossRefGoogle Scholar
Mounts, P., Shah, K. V. (1984) Respiratory papillomatosis: etiological relation to genital tract papillomaviruses. Progress in Medical Virology 29: 90114.Google ScholarPubMed
Pignatari, S., Smith, E. M., Gray, S. D., Shive, C., Turek, L. P. (1992) Detection of HPV infection in diseased and nondiseased sites of the respiratory tract in recurrent respiratory papillomatosis patients by dot blot hybridization. Annals of Otology, Rhinology and Laryngology 101: 408412.CrossRefGoogle Scholar
Quick, C. A., Foucar, E., Dehner, L. P. (1979) Frequency and significance of epithelial atypia in laryngeal papillomatosis. Laryngoscope 89: 550560.CrossRefGoogle ScholarPubMed
Simma, B., Burger, R., Uehlinger, J., Ghelfi, D., Hof, E., Dangel, P., Briner, J., Fanconi, S. (1993) Squamous cell carcinoma arising in a non-irradiated child with recurrent respiratory papillomatosis. European Journal of Pediatrics 152: 776778.CrossRefGoogle Scholar
Snoeck, R., Van Ranst, M., Andrej, G., De Clercq, E., De Wit, S., Poncin, M., Clumeck, N. (1995) Treatment of anogenital papillomavirus infections with an acyclic nucleoside phosphonate analogue. New England Journal of Medicine 333: 943945.CrossRefGoogle ScholarPubMed
Steinberg, B. M., Topp, W. C., Schnedier, P. S., Abramson, A. L. (1983) Laryngeal papillomavirus infection during clinical remission. New England Journal of Medicine 308: 12611264.CrossRefGoogle ScholarPubMed
Stoppler, H., Stoppler, M. C., Schlegel, R. (1994) Transforming proteins of the papilloma viruses. Intervirology 37: 3546.CrossRefGoogle Scholar
Strong, M. S., Vaughan, C. W., Healy, G. B. (1979) Recurrent respiratory papillomatosis. In Laryngotracheal Problems in the Pediatric Patient. (Healy, G. B., McGills, A., eds.). Charles C. Thomas, Springfield, III, USA. pp. 88118.Google Scholar
Tan, L. K., Dowell, S. P., Ogden, G. R. (1996) Antigen retrieval: p53 staining in benign, premalignant and malignant tissues of the larynx. Clinical Otolaryngology 21(2): 147150.CrossRefGoogle ScholarPubMed