Malignant Conversion of a Solitary Papilloma in the Distal Trachea: Report of a Case

Lioulias, Achilleas; Misthos, Panagiotis; Papagiannakis, George; Mermigkis, Dimitrios; Karagianidis, Napoleon; Neofotistos, Kostas; Kokotsakis, John

doi:10.1155/2008/908308

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…To the best of our knowledge, only four cases of malignant transformation of a solitary papilloma in the trachea had been reported in the English literature until 2012 (12,13).…”

Section: Discussionmentioning

confidence: 99%

Malignant conversion of a solitary squamous cell papilloma in the trachea treated by radiotherapy: A case report

Feng¹,

Wang²,

Chen³

et al. 2015

Oncology Letters

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Abstract. The present study described a rare case of malignant conversion of a solitary papilloma in the trachea, in addition to reviewing the current literature. A 54-year-old male presented with a cough, sputum and dyspnea. Chest computed tomography revealed a mediastinal soft-tissue mass in the trachea. A tumor biopsy, performed using a flexible bronchofiberscope, identified a squamous cell papilloma with moderate to severe atypical hyperplasia, as well as the formation of squamous cell carcinoma. Polymerase chain reaction analysis did not detect presence of human papilloma virus in the tumor. The patient was subsequently treated with radiotherapy and no evidence of recurrence was observed during a two-year follow-up period. To the best of our knowledge, this is the first study to describe the malignant conversion of a solitary papilloma in the trachea, which was subsequently treated with radiotherapy.

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“…To the best of our knowledge, only four cases of malignant transformation of a solitary papilloma in the trachea had been reported in the English literature until 2012 (12,13).…”

Section: Discussionmentioning

confidence: 99%

Malignant conversion of a solitary squamous cell papilloma in the trachea treated by radiotherapy: A case report

Feng¹,

Wang²,

Chen³

et al. 2015

Oncology Letters

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“…Due to its non‐specific clinical presentations misdiagnosis of asthma and bronchitis is frequent 1–4 . Indeed, asthma‐like symptoms were present in the current patient and the initial diagnosis was of asthma but the failure of therapy led us to assess causes of upper airway obstruction.…”

mentioning

confidence: 86%

“…The prognosis of papillomas located in the trachea, bronchi and lung tissue is poor, with high tendency to recurrence and approximately 3–7% undergo malignant conversion (squamous cell carcinoma) 2,3 . Close follow up including control chest X‐rays and a bronchoscopy (last control) in three follow ups in 1 year showed no sign of recurrence or disease progression.…”

mentioning

confidence: 96%

Respiratory papillomatosis primarily arising in the trachea

İmamoğlu¹,

Bahadır

2012

Pediatrics International

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Respiratory papillomatosis (RP), caused by the human papilloma virus (HPV), arising primarily in the trachea without obvious laryngeal lesion is rarely reported. 1 We present a case of RP arising primarily in the trachea, which was previously misdiagnosed as asthma.A 15-year-old boy was admitted to the emergency department with severe respiratory distress. He had been suffering from coughing, wheezing, and exercise-induced asthma episodes for the previous 3 months, and the symptoms had gradually worsened over the recent weeks. He had obvious intercostals retractions and stridor. He was given oxygen at 4 L/min by mask and treated with bronchodilators and steroids. Arterial blood gas analysis was PCO2, 51 mmHg; PO2, 81 mmHg; and SAT O2, 88.From his history of progressive worsening of the symptoms despite asthma treatment, causes of upper airway obstruction were assessed. On chest X-ray, peribronchial cuffing, focal radiolucent and opaque areas were detected. Chest computed tomography (CT) showed an intraluminal tumor located in the lower one-third of the trachea (Fig. 1). There was peribronchial thickening and centrilobular nodules in the perivascular structures, which were more concentrated in the left lung, suggestive of viral interstitial pneumonia.Emergency rigid bronchoscopy showed a spherical mass with an irregular surface attached to the tracheal wall through a narrow pedicle occluding approximately 60% of the lumen at 1 cm to the carina of the trachea. The tumor was removed completely using biopsy forceps with no complications, and significant clinical improvement was obtained. Laryngomicroscopy was normal. Pathology of the specimens indicated squamous cell papilloma (Fig. 2) and HPV was identified on polymerase chain reaction.The prognosis of papillomas located in the trachea, bronchi and lung tissue is poor, with high tendency to recurrence and approximately 3-7% undergo malignant conversion (squamous cell carcinoma). 2,3 Close follow up including control chest X-rays and a bronchoscopy (last control) in three follow ups in 1 year showed no sign of recurrence or disease progression.Due to its non-specific clinical presentations misdiagnosis of asthma and bronchitis is frequent. 1-4 Indeed, asthma-like symptoms were present in the current patient and the initial diagnosis was of asthma but the failure of therapy led us to assess causes of upper airway obstruction.There is only limited information on treatment of RP with trachea and lung involvement. Papilloma in the trachea is amenable to excision through endoscopic surgery. Adjuvant intralesional pharmacological agents are not routinely used. In cases

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