Squamous Cell Carcinoma of the Respiratory Tract Following Laryngeal Papillomatosis

Abstract

With the object to disclose an association between laryngeal papillomatosis and laryngeal carcinoma, we reviewed 102 patients with laryngeal papillomatosis treated between 1950 and 1979. Seven cases of laryngeal carcinomas were recorded and 1 patient with spread of papilloma to the bronchial tree developed a bronchial carcinoma. The time between onset of papilloma and diagnosis of carcinoma was 4-55 years (mean 24 years). For laryngeal carcinoma the ratio of observed to expected cases was 88. Of the 8 patients developing respiratory tract carcinoma, 2 had received treatment with radiation and 2 had been treated with Bleomycin. Four of these 8 patients were known smokers. This study shows that papillomatosis is more often associated with laryngeal carcinoma than previously reported. It appears, however, that laryngeal papillomas alone seldom induce carcinomas. Apart from irradiation and smoking, Bleomycin could be an important co-factor.

Malignant Transformation of Recurrent Respiratory Papillomatosis Associated With Integrated Human Papillomavirus Type 11 DNA and Mutation of p53

“…Despite the multiple therapeutic protocols used by physicians, no consistently effective treatment of RRP is available 10 . Frankly malignant, metastasizing squamous cell carcinoma (SCC) can be associated with papillomatosis, usually after irradiation or bleomycin chemotherapy, but may also occur in patients with a history of cigarette smoking 11‐12 . Carcinoma may also develop without any known carcinogenic risk factors 12‐15 …”

Malignant transformation in non-irradiated juvenile laryngeal papillomatosis

“…On the other hand, there are cases reported in which malignant transformation was observed in the absence of any carcinogenic causes, especially smoking [2,5,8,10,25]. Some authors have suggested that interaction of exogenous factors such as chemical toxins, chemotherapy and irradiation, together with human papillomavirus promoters, leads to malignant changes [13].…”

Role of TP53 P72R polymorphism in human papillomavirus associated premalignant laryngeal neoplasm

“…Laryngeal papillomatosis, a disease in which malignant transformation takes place in 3-7% of patients,1 2 is caused by low risk human papillomavirus (HPV) types 6 and 11. The mechanism by which HPV affects TP53 involves the HPV E6 oncoprotein, which has been shown to bind TP53 protein and cause its degradation through the ubiquitin pathway 3.…”