1/5. Recurrent juvenile-onset laryngotracheal papillomatosis with transformation to squamous cell carcinoma of the lung.A 47-year-old female patient with recurrent juvenile-onset laryngotracheal papillomatosis for 27 years had multiple bilateral pulmonary lesions, the largest of which was a well-differentiated squamous cell carcinoma. This case is unique because the malignant transformation occurred in a nonirradiated, nonsmoking patient.- - - - - - - - - - ranking = 1keywords = juvenile-onset (Clic here for more details about this article) |
2/5. Squamous cell carcinoma arising in recurrent respiratory papillomatosis with pulmonary involvement: emerging common pattern of clinical features and human papillomavirus serotype association.Squamous papillomas of the lung are an uncommon feature of recurrent respiratory papillomatosis, occurring in fewer than 1% of cases. We describe a 23-year-old patient with pulmonary papillomas who developed a fatal squamous cell carcinoma of the lung. PCR-based human papillomavirus (HPV) typing showed the presence of HPV 11 DNA in both benign papillomas and invasive carcinoma. A review of the literature reveals four reports of malignant transformation of juvenile-onset recurrent respiratory papillomatosis in which HPV typing was performed. Similar clinical features are noted in all of the reports; specifically, each case has arisen in a young adult man with a history of papillomatosis since childhood. In each of the cases, HPV 11 was identified in association with the squamous cell carcinoma. Although HPV 11 is uncommonly associated with the development of invasive carcinoma at other sites, these findings suggest that it is correlated with malignant transformation in the setting of juvenile-onset recurrent respiratory papillomatosis.- - - - - - - - - - ranking = 0.4keywords = juvenile-onset (Clic here for more details about this article) |
3/5. Pulmonary involvement in a case of juvenile-onset recurrent respiratory papillomatosis.Juvenile-onset recurrent respiratory papillomatosis is primarily a disease of children and adolescents. Although most patients experience spontaneous regression at a later age, some patients continue to be affected throughout their lives. We report the case of a 35-year-old woman with a 33-year history of juvenile-onset recurrent respiratory papillomatosis who developed pulmonary dissemination with malignant transformation. Malignant transformation is the most feared sequela of pulmonary dissemination, and it should be addressed aggressively. If treated promptly, the patient can enjoy prolonged survival. Computed tomography is superior to plain radiography for detecting and evaluating the extent of disease.- - - - - - - - - - ranking = 1keywords = juvenile-onset (Clic here for more details about this article) |
4/5. Human papillomavirus type 11 DNA in squamous cell carcinomas and pre-existing multiple laryngeal papillomas.The case histories of 4 patients are presented, who developed an invasive squamous cell carcinoma from pre-existing multiple laryngeal papillomatosis (two juvenile-onset and two adult-onset) during a long latency period. A series of 14 routinely processed, paraffin-embedded biopsies obtained from these patients (including both benign papillomas and carcinomas) were analysed using in situ DNA-hybridization technique with 35S-labelled Human papillomavirus (HPV) dna probes of HPV types, 6, 11, 16, 18 and 30. The lesions were also assessed by indirect immunoperoxidase (IP-PAP) technique to demonstrate the expression of HPV structural proteins. On light microscopy, morphology was consistent with HPV infection in all 14 biopsies. HPV antigen expression could not be demonstrated in any of the papillomas or carcinomas, however. HPV 11 DNA was present in high copy numbers in both the benign and malignant lesions of 2 patients, both presenting with the juvenile-onset disease. The present findings provide support for the role of HPV as an etiological agent in laryngeal squamous cell carcinoma, most probably acting synergistically with chemical or physical carcinogens (one patient received irradiation and 2 others were smokers). It seems clear that an infection by the 'low risk' HPV types 6 and 11 by no means excludes the possibility of developing a laryngeal malignancy, so far ascribed to the 'high risk' type HPV 16 only.- - - - - - - - - - ranking = 0.4keywords = juvenile-onset (Clic here for more details about this article) |
5/5. carcinoma ex-papilloma: histologic and virologic studies in whole-organ sections of the larynx.A patient with adult-onset recurrent respiratory papillomatosis (RRP), initially diagnosed at age 28 years, was treated with radiation therapy due to the rapid regrowth of lesions. Following 6 years of apparently inhibited growth, papilloma recurred, and squamous carcinoma was diagnosed from a laryngeal biopsy. A spontaneous laryngocutaneous fistula developed, and laryngectomy was performed 14 years after irradiation. The laryngectomy specimen was snap frozen and representative tissues were stored frozen for viral studies. The larynx was whole-organ sectioned for histologic examinations; residual papilloma, as well as carcinoma, was observed. Koilocytosis and other virus-associated histologic changes were also found. HPV capsid antigen was present in papilloma, carcinoma, and clinically normal epithelium. HPV nucleic acids, conforming to HPV type 6, were present in keratin pearls and dysplastic cells. According to prior reports, carcinoma developing in preexisting papilloma arises from juvenile-onset RRP. Irradiated papilloma develop cancer at about 10 years, and the patients rarely survive. Nonirradiated cases develop cancer after 30 years, and some develop papilloma in the hypopharynx and trachea, but most patients survive. Irradiation is not an obligatory precursor for malignant transformation of cancer; however, until now there have been no case reports of favorable outcome after irradiation of papilloma.- - - - - - - - - - ranking = 0.2keywords = juvenile-onset (Clic here for more details about this article) |