Virtual Hospital: Radiology Resident Case of the Week: Laryngeal Tracheopapillomatosis with Lung Involvement

Radiology Resident Case of the Week

Laryngeal Tracheopapillomatosis with Lung Involvement

May 10, 1996

Ronald W. Fuller, M.D.
Peer Review Status: Not reviewed

Clinical Sx:
Papilloma is the most common tumor of the larynx in childhood. It rarely becomes malignant and usually disappears after puberty. The pink warty tumor may occur anywhere in the larynx but usually arises from the vocal folds. The disease is caused by human papillomavirus which is passed from the maternal vaginal condyloma, aspirated at delivery, and produces disease in a small fraction of exposed infants.

The initial symptoms include hoarseness but dyspnea and asphyxia can occur. Tracheostomy is occasionally required.

Direct laryngoscopy accomplishes both diagnosis and treatment. Surgery, cryosurgery, and laser ablation have all been advocated. If a patient with larygobronchial papillomatosis fails to respond to the usual treatment, they may improve with systemic bleomycin. Less than 1% of laryngeal tracheopapillomatosis spreads to the lungs which may cause cystic or solid lesions.

Etiology/Pathophysiology

Pathology:

Miscellaneous

Imaging
CT examination of the chest is the imaging modality of choice for lung lesions.

DDX

Key references
Nelson Textbook of Pediatrics, 13th Ed., p894-895 Essentials fo Caffey's Pediatric X-ray Diagnosis, p333.

ACR Code

Keywords:

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