Cases Of Recurrent Respiratory Papillomatosis Research Articles

Presence of HPV type 6 in dysplasia and carcinoma arising from recurrent respiratory papillomatosis

We collected rare cases of recurrent respiratory papillomatosis (RRP) undergoing malignant transformation. We sought to identify human papillomavirus (HPV) subtypes in areas of papilloma, dysplasia, and carcinoma and investigate the pattern of protein overexpression. Three patients whose disease underwent malignant transformation from RRP to carcinoma were subjected to this study. Morphologically distinct areas in the pathology specimen of each patient were diagnosed as papilloma, dysplasia, and carcinoma. Each lesion was separately obtained by laser capture microdissection and was PCR amplified for the presence of HPV. A DNA chip was used to determine the type of HPV in each area. Immunohistochemistry for p53, Ki-67, and pRb was performed. HPV type 6 was present in all specimens tested positive. Expression of p53 and Ki-67 increased with increasing severity of dysplastic change. Although HPV type 11 is most frequently associated with malignant change of RRP, HPV type 6 may also contribute to play an equally important role in RRP carcinogenesis.

Detection of hormone receptors in the human vocal fold

Until now only limited and controversial data are available concerning the presence of steroid hormone receptors in the human vocal fold. A sum of 140 slides from 104 patients were investigated including 25 Reinke's edemas, 19 cases of recurrent respiratory papillomatosis, 19 polyps, 10 epithelial hyperplasias without or with dysplasias, 4 carcinomas in situ, 20 laryngeal carcinomas as well as 7 fresh cadaver samples without macroscopic alterations. The median patient age was 58 years. Paraffin-embedded tissue was incubated with monoclonal antibodies for estrogen-alpha, androgen and progesterone. Androgen receptors were expressed most frequently, followed by estrogen receptors, whereas no progesterone receptors were identified. Receptor staining could be detected with different densities and locations within the different vocal fold pathologies, but not in the autopsy samples. Our study could clearly demonstrate the presence of hormone receptors in the human vocal fold. Androgen receptors were most frequently detected, especially in the basal and intermediate layer of the stratified epithelium and the lamina propria. Whether the high incidence of steroid hormone receptors in some vocal fold pathologies has implications on their pathogenesis must be evaluated by further studies.

HPV type 6 and 16 co-infection in a 11-year-old girl presenting laryngeal papillomatosis

Recurrent respiratory papillomatosis (RRP) is a rare and enign neoplasm of the larynx in children; it can, in rare ases (<1%), spread along the entire aerodigestive tract. n the USA, its incidence is estimated at approximately .3/100,000 children (Derkay, 2001), and in France its freuency is approximately 300 cases/year (Francois, 2000). linically it consists of a mild dysphonia, which may progress o aphonia. It may be complicated by pneumonia, acute espiratory insufficiency and asphyxia. Recurrence of juveile RRP poses problems of management since it needs a ong term follow-up including endoscopies with multiple urgical procedures and sometimes tracheotomy in case of espiratory distress. In most studies, RRP are benign squaous cell proliferations mainly due to HPV types 6 or 11 Abramson et al., 2004; Derkay and Darrow, 2000; Syrjanen nd Syrjanen, 2000). HPV type 6 is the most frequently found PV type (Hartley et al., 1994). Co-infection with multiple ypes of HPV, in particular high-risk (HR) HPV types such s HPV type 16 have been rarely described in RRP (Dickens t al., 1991; Doyle et al., 1994; Penaloza-Plascencia et al., 000). We report a case of RRP in a young 11-year-old girl preenting with HPV types 6 and 16 co-infection diagnosed sing PCR-sequencing technique followed by phylogenetic nalysis.

Severe Recurrent Respiratory Papillomatosis in an HIV-infected Adult on Highly Active Antiretroviral Therapy

Abstract: Abstract: Patients with HIV have an increased risk of human papilloma virus (HPV) disease that is related to the degree of immunosuppression. Anogenital, cutaneous, and oral warts are the more common HPV-related symptoms that affect patients with HIV. Recurrent respiratory papillomatosis (RRP), a disease caused by HPV, has been well described in children and adults. However, to our knowledge, there are no other cases in the English language literature describing RRP after highly active antiretroviral therapy (HAART) in patients with HIV. We present a case of aggressive RRP in a patient with HIV receiving antiretroviral therapy. Clinicians should be aware of RRP as a potential cause of airway symptoms in patients with HIV as their immune system reconstitutes.

Remote intrapulmonary spread of recurrent respiratory papillomatosis with malignant transformation

Recurrent respiratory papillomatosis is the most common neoplasm of the larynx in childhood. Extension into lung parenchyma occurs in less than 1% of patients and has a low risk of malignant transformation. Treatment options for intrapulmonary spread have shown limited success. We describe a case of recurrent respiratory papillomatosis with extensive parenchymal involvement and adenosquamous carcinoma in a 14-year-old girl.

Recurrent Respiratory Papillomatosis

A 6-year-review of patients who presented with recurrent respiratory papillomatosis (RRP) to our hospital from January 1996 to December 2001 was carried out. Ten cases were identified, of which six were juvenile-onset RRP. Hoarseness was the most common symptom, noted in nine (90%) patients. Other clinical presentations included cough, stridor and aphonia. All patients had glottic papillomas; two had multiple sites of involvement. One patient underwent a tracheostomy that revealed papillomas over the trachea, bronchus and lung parenchyma. Half of the patients were Chinese. Of the six cases of juvenile-onset RRP, three patients were Malay, two Chinese and one Indian. Three Chinese and one German patient had adult-onset RRP. Among the juvenile-onset RRP cases, the mean age at presentation was 2 years, while for adult-onset RRP, it was 42 years. Juvenile-onset RRP was more common in females. There were more papillomas over more sites in patients with juvenile-onset RRP than with adult-onset disease. Subglottic involvement was noted in the juvenile-onset RRP cases. All patients were treated with CO2 laser therapy, but there was complete remission of the papillomas in only two cases.

Recurrent respiratory papillomatosis with esophageal involvement

Objective: to report a case of recurrent respiratory papillomatosis with diffuse involvement of the esophagus in a child. Design: retrospective case report and literature review. Setting: Tertiary Children's Hospital. Conclusion: endoscopy is recommended for detection of esophageal papillomas, especially in patients with significant laryngeal lesions or post-cricoid involvement.

Topoisomerase Alpha II, Retinoblastoma Gene Product, and p53: Potential Relationships With Aggressive Behavior and Malignant Transformation in Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) has a juvenile aggressive form and an adult more indolent form. Most cases of RRP are cytologically benign; however, some undergo malignant transformation. At present, there are no known markers that help identify patients at risk for aggressive disease. We investigated by immunohistochemistry expressions of topoisomerase alpha II, MIB-1, p53, p21, E-cadherin, retinoblastoma (RB) gene protein product, HER-2/neu, and steroid hormone receptors in a case of juvenile respiratory papillomatosis with malignant transformation to determine whether these markers are associated with malignant transformation. Histologic examination of the pulmonary lobectomy specimen revealed well-differentiated squamous carcinoma and invasive papillomatosis. Increased staining was found in areas of invasive papillomatosis for topoisomerase alpha II, p53, and MIB-1, with highest labeling indices in areas of squamous carcinoma. Staining intensity for RB gene protein product showed gradual decline from benign papilloma (3+) and invasive papillomatosis (2+) to squamous carcinoma (0-1+). Expression of p21 was similar in benign papilloma and invasive papillomatosis but showed reduction in squamous carcinoma. Expressions of E-cadherin, HER-2/neu, and steroid hormone receptors did not appear to correlate with biologic behavior. Increased topoisomerase alpha II and p53 expression along with reduced RB gene protein product and p21 expression may serve as markers of transformation to invasive papillomatosis and squamous carcinoma.

Incidence and prevalence of recurrent respiratory papillomatosis among children in Atlanta and Seattle.

The incidence and prevalence of recurrent respiratory papillomatosis (RRP) for children aged <18 years were estimated in 2 US cities, Atlanta and Seattle, in 1996. All otolaryngologists in a 24-county area in metropolitan Atlanta (101 physicians) and an 8-county area in metropolitan Seattle (139 physicians) agreed to participate in the study. Medical record chart abstraction was performed only for children with documented current residence in the study area (21 patients in Atlanta and 14 patients in Seattle). The incidence rate for juvenile RRP was 1.11/100,000 population in Atlanta and 0.36/100, 000 in Seattle. The prevalence rate was 2.59/100,000 population in Atlanta and 1.69/100,000 in Seattle. In neither city did prevalences differ significantly when stratified by sex or race. Extrapolation of these estimates to the US population suggests that 80-1500 incident cases and 700-3000 prevalent cases of juvenile RRP will occur in the United States during 1999.

Recurrent respiratory papillomatosis: a 10 year study.

Sixty cases of recurrent respiratory papillomatosis in both children and adults treated over a 10 year period were reviewed. An unexpected finding was that nine of the 60 patients (15 per cent) had symptoms by two months of age; an earlier onset than previously described. The control rate was 66 per cent for paediatric onset patients and 44 per cent with adult onset; the former required more operations. No anaesthetic deaths or complications were encountered. Glottic webs were the only surgical complication. The findings confirm that there is no relationship between puberty and the rate of control or recurrence. The necessity for precise and comprehensive endoscopic examination of the upper aerodigestive tract using a range of endoscopes and rigid telescopes under general anaesthetic is emphasized.