Squamous-cell carcinoma arising in a non-irradiated child with recurrent respiratory papillomatosis

Abstract

We describe a patient with recurrent respiratory papillomatosis (RRP) associated with human papilloma virus (HPV), who developed a fatal squamous cell carcinoma of the lung. At the age of 1 year he presented with hoarseness, dyspnoea and inspiratory stridor but the diagnosis of RRP was made only 1 year later. At the age of 4 years he was tracheostomized because of upper airway obstruction. In spite of multiple surgical excisions and topic treatment with 5-fluorouracil the papillomata extended to the lung parenchyma. At the age of 16 years he developed a squamous-cell carcinoma of the lung and died 4 months later. Transformation to pulmonary carcinoma is a rare complication in non-irradiated patients with lung papillomatosis. We found only 11 similar cases in the literature.

Lung involvement in juvenile onset recurrent respiratory papillomatosis: A systematic review of the literature

“…Fourteen patients, however, had tests for multiples types, including types 16 and 18 [1,14,28,30,37,41,52,85,92,100,105]. The other publications did not differentiate between type 6 and 11 [40,71,77] or type 16 and 18 [3,59]. There were only 2 patients for which HPV 16 (labelled a high-risk type) was identified in association, one with HPV 6 [36] and one with both HPV 6 and HPV 11 [37].…”

Metastatic squamous-cell carcinoma of the lung arising in a 12-year-old boy with juvenile recurrent respiratory papillomatosis of neonatal onset

“…JRRP is due to infection with Human Papilloma Virus (HPV) mainly of type 6 and 11 (2,5,6,7). Although these HPV types are thought to be of «low risk» in the genitary tract, patients with JRRP can develop broncho-pulmonary carcinoma, especially those who receive radiation or cytotoxic drugs or subsequently smoke (8).…”

HPV infections and lung cancer

“…10 Indeed, such SCJs are readily detectable at various locations in the upper respiratory tract and in bronchial spurs, 2 3 7 8 explaining the frequently widespread dissemination of multiple laryngeal papillomatosis down to the trachea and bronchi. 11 12 This multiple papillomatosis and the not uncommon occurrence of malignant transition into squamous cell carcinoma (SCC) of the trachea and bronchi [13][14][15] are currently thought to be manifestations of the recurrent respiratory papillomatosis (RRP) syndrome. 1-3 6-8 This syndrome is outside the scope of this review, which is focused on the evidence linking HPV to primary bronchial tumours only.…”