Complicated tracheo-bronchial papillomatosis

Abstract

Respiratory papillomas are rare benign lesions. They are characterized by the appearance of papillomatous lesions anywhere in the tracheo-bronchial tree. It affects children and young adults. Although the disease affects mainly the upper airways, it may be aggressive and extends distally to the lower respiratory tract and pulmonary parenchyma. The course of the disease is unpredictable. It may regress spontaneously, but in other instances, it may lead to serious complications ranging from airway obstruction up to malignant transformation. Surgical excision is the mainstay of definitive treatment to prevent recurrence and to exclude malignancy. We have reviewed the literature for this rare type of respiratory disease and present a thirtyfive years old; male patient who had chronic cough and was referred to our unit with a CT-chest that revealed left main endo-bronchial lesion. Bronchoscopy and biopsy of the lesion were performed and revealed squamous papilloma. Final treatment introduced to the patient was endoscopic thermal ablation. However, the final pathology revealed complicated squamous bronchial papilloma with infection by aspergillosis and actinomycosis.