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.