Pulmonary Spread of Juvenile Laryngeal Papillomatosis: A Case Report

Introduction: Recurrent respiratory papillomatosis (RRP) is usually a relatively benign disease but can have an aggressive clinical course. The primary treatment for laryngeal papillomatosis is endoscopic resection. However, there is no effective treatment for pulmonary spread of laryngeal papillomatosis. Case Presentation: We describe a rare case of a 19-year-old man with pulmonary spread of laryngeal papillomatosis. The treatment regimen was surgical resection under general anesthesia using suspension laryngoscopy and endoscopy. The patient had been diagnosed with laryngeal papillomatosis and had undergone a tracheotomy when he was 18 months old. He underwent 17 endoscopic resections for laryngeal papillomatosis at intervals of 3 months to 1 year. At follow-up, the patient continued to have tracheal intubation and was not extubated. CT scans revealed multiple nodular and cavitary lesions in both lungs. Laryngoscopy performed when the patient was 18 years showed diffuse papillomata in the glottis and left ventricular fold. Conclusions: This article presents a rare case of juvenile laryngeal papillomatosis associated with the human papilloma virus (HPV) HPV-11 and pulmonary spread. Intravenous cidofovir has oncogenic potential, but it has been used successfully to treat five patients with pulmonary spread of RRP. Intravenous cidofovir should be considered as salvage therapy.