Pulmonary spread of tracheobronchial papillomatosis

Case contributed by Maxim Stalkov

Presentation

Long history of voice changes, cough and dyspnea. Recent exacerbation with asphyxia requiring tracheostomy.

Patient Data

Age: 40
Gender: Male

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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