Recurrent Respiratory Papillomatosis Successfully Treated with Gefitinib: A Case Study

Abstract

Background: Recurrent respiratory papillomatosis (RRP) is a rare condition caused by infection of the respiratory tract mucosa with human papillomaviruses. The disease is characterized by a growth of mucosal papillomas, mostly in the laryngeal region and rarely in the more distal parts of the airways. The therapy is often difficult, including both mechanical removal of papillomas and pharmacological therapy. Methods: Presented in the article is a case of regression of papillomatosis in the larynx, trachea and lung parenchyma after administration of gefitinib, an endothelial growth factor receptor inhibitor. The literature review is added into this article to give more information about the etiology, clinical features and treatment. Results: The authors report a case of 42-year-old Caucasian female, recurrent respiratory papillomatosis was diagnosed in her first year of life. Papillomas were primarily diagnosed in the vocal cord region. Both pharmacological and frequently repeated invasive treatment brought no effective solution; by contrast, papillomas spread to the distal airways. A decision to administer gefitinib was made after other treatment modalities had failed. As early as two months later, the therapeutic effect was observed, with regression of both laryngotracheal and pulmonary involvement. Conclusions: Tyrosine kinase inhibitors of epidermal growth factor receptor represent a new treatment possibility for a long-term benefit for patients with recurrent respiratory papillomatosis in whom other modalities failed.