Presentation
Long history of voice changes, cough and dyspnea. Recent exacerbation with asphyxia requiring tracheostomy.
Patient Data
Multiple cavitating nodules and masses bilaterally with posterior and basal predilection. Numerous endoluminal tracheal soft-tissue lesions obstructing upper airways. Tracheostomy tube in place.
Findings are suggestive of pulmonary spread of tracheobronchial papillomatosis.
Case Discussion
Tracheobronchial papillomatosis is caused by human papilloma virus types 6 and 11. Less than 1% of patients with tracheobronchial papillomatosis have parenchymal extension. Juvenile onset type usually have a worse prognosis with higher incidence of pulmonary spread. Proposed mechanism of spread is associated with aerial dissemination of papilloma fragments facilitated by laryngeal and tracheal interventions.
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