Malignant Changes in Nonirradiated Juvenile Laryngotracheal Papillomatosis

Bewtra, Chhanda; Krishnan, Rohini; Lee, Steve S.

doi:10.1001/archotol.1982.00790500050012

Cited by 34 publications

(8 citation statements)

References 13 publications

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“…Both these patients were later found to have squamous cell car- cinoma. Similar findings were reported (Seigel et al, 1979;Bewtra et al, 1982;Kashima et al, 1988).…”

Section: Tracheostomysupporting

confidence: 89%

Clinical features of malignant transformation in benign laryngeal papillomata

Singh

Ramsaroop

1994

J. Laryngol. Otol.

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Laryngeal papillomata can undergo spontaneous malignant transformation without being detected histologically and, in some instances, the disease may become so advanced, before the diagnosis is confirmed, that it is beyond any form of curative treatment.Because of this limitation imposed by histopathological investigation, a study was undertaken in 17 adults with benign laryngeal papillomata, (three of whom underwent malignant transformation) to determine whether malignant transformation can be predicted from the clinical behaviour of the tumour. The following features were analysed: age, sex, patient's symptoms, frequency of excision of the papillomata, site of lesion, presence or absence of laryngeal oedema, the need for tracheostomy, vocal fold mobility and presence or absence of cervical lymph nodes.It was found that decreased vocal fold mobility, the presence of cervical lymph nodes, exuberant and rapid growth requiring very frequent excisions, oedema of the larynx with airway obstruction requiring a tracheostomy are clinical features suggestive of malignant transformation.

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“…Both these patients were later found to have squamous cell car- cinoma. Similar findings were reported (Seigel et al, 1979;Bewtra et al, 1982;Kashima et al, 1988).…”

Section: Tracheostomysupporting

confidence: 89%

Clinical features of malignant transformation in benign laryngeal papillomata

Singh

Ramsaroop

1994

J. Laryngol. Otol.

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“…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 …”

Section: Introductionmentioning

confidence: 99%

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

et al. 1998

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Recurrent respiratory papillomatosis (RRP), usually confined to the nasopharynx, trachea, and larynx, occasionally can progress to extensive bronchopulmonary disease. Most cases of bronchopulmonary and laryngeal papillomatosis are cytologically benign and do not undergo malignant transformation; however, squamous cell carcinoma (SCC) can arise in RRP in the absence of known risk factors such as radiation and smoking. In this study, the authors investigated molecular genetic alterations occurring in a case of metastasizing SCC that arose in long-standing bronchopulmonary papillomatosis. Genomic DNA from tracheal papillomata, tracheobronchial papillomata, SCC of the lung, and a lymph node metastasis was extracted. The physical state of the human papillomavirus type 11 (HPV-11) DNA was investigated by two-dimensional gel electrophoresis. Molecular genetic alterations of the host genome were studied by direct sequencing of polymerase chain reaction-amplified gene fragments and restriction fragment length polymorphism (RFLP) analysis. Episomal and integrated forms of HPV-11 sequences were detected in histologically benign tumors, but only the integrated form of the viral DNA could be found in malignant tissue samples. Molecular genetic studies revealed that an allelic loss of the interferon-beta gene (IFNbeta-1) and an endogenous type of mutation of the p53 antioncogene were found only in the malignant lesions. Mutations were not observed in the ras, neu, or multiple tumor suppressor (MTS1/p16) genes in any specimens. The authors' data indicated that the p53 genetic mutation was associated with integration of HPV-11 in histologically malignant lesions. This association may promote a progressive genetic instability that can lead to the development and clonal expansion of malignant lesions in RRP.

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“…All of our patients were or had been smokers, but it is not clear whether the patient's smoking history con- tributed to the neoplastic transformation of their 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].…”

Section: Discussionmentioning

confidence: 99%

Malignant transformation in non-irradiated juvenile laryngeal papillomatosis

Rehberg

Kleinsasser

1999

European Archives of Oto-Rhino-Laryngology

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A spontaneous cancer transformation of non-irradiated juvenile papillomas has been observed in a very small number of cases. We report on six more patients with juvenile laryngeal papillomatosis developing into a squamous-cell carcinoma. Three patients had childhood papillomatosis and three patients adult onsets of their papillomas. The average duration between onset of papillomatosis and cancer diagnosis was 33 years, while the average age at time of diagnosis of a laryngeal cancer was 50 years. All patients were cigarette smokers, but none of them had received prior irradiation. The typical histological picture of tumors showed an infiltrating keratinizing squamous carcinoma besides remaining benign papillomas within the larynx. Our study again illustrates the risk of malignant transformation of juvenile papillomatosis in long-lasting cases. Therefore, regular extensive biopsies and careful histopathological examination are required. The role of smoking as a co-factor in the development of carcinoma ex-papilloma is still not clear.

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Malignant Changes in Nonirradiated Juvenile Laryngotracheal Papillomatosis

Cited by 34 publications

References 13 publications

Clinical features of malignant transformation in benign laryngeal papillomata

Clinical features of malignant transformation in benign laryngeal papillomata

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

Malignant transformation in non-irradiated juvenile laryngeal papillomatosis

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