Recurrent laryngeal papillomatosis with pulmonary involvement: case report




Human Papilloma Virus, Respiratory Papillomatosis, Microsurgery


Recurrent respiratory papillomatosis is a neoplastic disease caused by the human papillomavirus and characterized by the growth of exophytic proliferative lesions affecting the mucosa of the respiratory tract. This condition has a bimodal age distribution; the juvenile form affects those under 20 years of age, is more aggressive and presents multiple papillomatous lesions and high frequency of recurrence, compared to the adult form. Pulmonary involvement is rare and challenging to treat. We present the case of a 13-year-old male with a history of laryngeal papillomatosis since the age of two years. The patient showed respiratory distress and multiple stenosing nodules in the larynx and trachea, as well as several pulmonary cysts identified on chest CT. The patient underwent excision of the papillomatous lesions and tracheostomy. Then, the patient received a single dose of intravenous bevacizumab 400 mg and respiratory therapies with favorable evolution, without recurrences during follow-up.


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The Recurrent Respiratory Papillomatosis Foundation [Internet]. RRPF. 2021. Disponible en:

Carifi M, Napolitano D, Morandi M, Dall’Olio D. Recurrent respiratory papillomatosis: current and future perspectives. Ther Clin Risk Manag. 2015;11:731–8. doi: 10.2147/TCRM.S81825.

Papilomatosis laríngea: una causa poco frecuente de disfonía en el niño. Serie de casos. Arch Argent Pediatr [Internet]. 2018;116(3). doi: 10.5546/aap.2018.e471.

Fortes HR, von Ranke FM, Escuissato DL, Araujo Neto CA, Zanetti G, Hochhegger B, et al. Recurrent respiratory papillomatosis: A state-of-the-art review. Respir Med. 2017;126:116-121. doi: 10.1016/j.rmed.2017.03.030.

Chraff S, Derkay CS, Burke B, Lawson L. American Society of Pediatric Otolaryngology members’ experience with recurrent respiratory papillomatosis and the use of adjuvant therapy. Arch Otolaryngol Head Neck Surg. 2004;130(9):1039-42. doi: 10.1001/archotol.130.9.1039.

Kramer SS, Wehunt WD, Stocker JT, Kashima H. Pulmonary manifestations of juvenile laryngotracheal papillomatosis. AJR Am J Roentgenol. 1985;144(4):687–94.

García LM, Salazar Ospina JD, Hernández JS. Paciente con papilomatosis laringo-traqueobronquial recurrente y empiema at necessitatis. Acta Med Colomb. 2018;43(3):171–4. doi: 10.36104/amc.2018.1166.

Ivancic R, Iqbal H, deSilva B, Pan Q, Matrka L. Current and future management of recurrent respiratory papillomatosis. Laryngoscope Investig Otolaryngol. 2018;3(1):22–34. doi: 10.1002/lio2.132.

Lugo JA, Sainz N, González Heredia R, Sánchez Guerrero M, Mendoza Ibarra V, Pineda A, et al. Papilomatosis respiratoria recurrente: análisis del impacto económico en el tratamiento quirúrgico. Horiz Med. 2017;17(4):30–4. doi: 10.24265/horizmed.2017.v17n4.06.

Alcas O, Triveño A. Uso de coadyuvantes en el tratamiento de la papilomatosis laríngea en un hospital nacional de referencia. Rev Peru Med Exp Salud Publica. 2020;37(4):788-789. doi: 10.17843/rpmesp.2020.374.5282.

Salazar Reyna F, Campos Guevara F. Uso de la Vacuna para el Papiloma Virus Humano en el Tratamiento de la Papilomatosis Laríngea Recurrente Juvenil. Rev Peru Pediatr. 2013;66(4):246-48.

Alcas Arce O, Pacheco García M. Uso de bevacizumab (avastin) sublesional en papilomatosis laríngea recurrente. An Fac Med. 2016;77(3):283-5. doi: 10.15381/anales.v77i3.12422.

Alfano DM. Human papillomavirus laryngeal tracheal papillomatosis. J Pediatr Health Care 2014;28(5):451–5. doi: 10.1016/j.pedhc.2014.04.003.

Molodtsova V, Ryabova M, Dvorakovskaya I, Vasilyeva M, Akopov A. Recurrent respiratory papillomatosis with lung involvement. Respir Med Case Rep. 2018;25:323–6. doi: 10.1016/j.rmcr.2018.10.019.

Kurita T, Chitose S-I, Sato K, Sakazaki T, Fukahori M, Sueyoshi S, et al. Pathological mechanisms of laryngeal papillomatosis based on laryngeal epithelial characteristics: Pathological Mechanisms of Laryngeal Papillomatosis. Laryngoscope Investig Otolaryngol. 2019;4(1):89–94. doi: 10.1002/lio2.242.

Reeves WC, Ruparelia SS, Swanson KI, Derkay CS, Marcus A, Unger ER. National registry for juvenile-onset recurrent respiratory papillomatosis. Arch Otolaryngol Head Neck Surg .2003;129(9):976–82. doi: 10.1001/archotol.129.9.976.

Derkay CS. Recurrent respiratory papillomatosis. Laryngoscope. 2001;111(1):57–69. doi: 10.1097/00005537-200101000-00011.

Maïga S, Ndiaye C, Diouf M, Diallo BK, Ndiaye M, Diouf MS, et al. Laryngeal papillomatosis in Senegal: A ten-year experience. Eur Ann

Otorhinolaryngol Head Neck Dis. 2018;135(3):221–4. doi: 10.1016/j.anorl.2018.01.002.

Silverberg MJ, Thorsen P, Lindeberg H, Ahdieh-Grant L, Shah KV. Clinical course of recurrent respiratory papillomatosis in Danish children. Arch Otolaryngol Head Neck Surg. 2004;130(6):711–6. doi: 10.1001/archotol.130.6.711.

Best SR, Friedman AD, Landau-Zemer T, Barbu AM, Burns JA, Freeman MW, et al. Safety and dosing of bevacizumab (avastin) for the treatment of recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol. 2012;121(9):587–93. doi: 10.1177/000348941212100905.

Sidell DR, Nassar M, Cotton RT, Zeitels SM, De Alarcon A. High-dose sublesional bevacizumab (avastin) for pediatric recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol. 2014;123(3):214–21. doi: 10.1177/0003489414522977.

Rogers DJ, Ojha S, Maurer R, Hartnick CJ. Use of adjuvant intralesional bevacizumab for aggressive respiratory papillomatosis in children. JAMA Otolaryngol Head Neck Surg. 2013;139(5):496–501. doi: 10.1001/ jamaoto.2013.1810.





Case Report

How to Cite

Zumaeta-Saavedra E, Chiara-Chilet C, Maquera-Afaray J, Luna-Vilchez M. Recurrent laryngeal papillomatosis with pulmonary involvement: case report. Rev Peru Med Exp Salud Publica [Internet]. 2023 Mar. 24 [cited 2024 Jun. 19];40(1):111-4. Available from:

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