Boudjemaa Sabah, Leboulanger Nicolas, Daınese Linda, Cremoux Patricia De, Pointe Hubert Ducou Le, Coulomb Aurore
Department of Pathology, Hopital Armand Trousseau, PARIS, FRANCE.
Turk Patoloji Derg. 2014;30(2):133-6. doi: 10.5146/tjpath.2014.01238.
Juvenile recurrent respiratory papillomatosis is the most common benign neoplastic disease of the larynx in children, characterized by numerous squamous papillomas caused by Human Papilloma Virus type 6 and 11. HPV is thought to be acquired at the time of vaginal delivery from maternal genital condylomas. Juvenile recurrent respiratory papillomatosis can be protracted by surgical interventions performed to avoid airway obstruction and extend below the vocal cords as far as the main stem bronchi. Lung involvement in Juvenile recurrent respiratory papillomatosis seems to be more prevalent than non-systematic reviews have reported until now and progression to cancer occurs in a significant proportion of these cases at a younger age than previously reported. This would suggest that closer attention should be paid to these children. We report a case of malignant transformation in a 12 year-old boy followed-up since the birth for an invasive juvenile recurrent respiratory papillomatosis with pulmonary involvement. The presence of HPV 6/11 was demonstrated by PCR analysis performed on material obtained from a metastatic vertebral lesion.
青少年复发性呼吸道乳头状瘤病是儿童喉部最常见的良性肿瘤性疾病，其特征是由6型和11型人乳头瘤病毒引起的大量鳞状乳头状瘤。人乳头瘤病毒被认为是在阴道分娩时从母体生殖器尖锐湿疣感染而来。为避免气道阻塞而进行的手术干预可使青少年复发性呼吸道乳头状瘤病病程延长，病变可延伸至声带以下直至主支气管。青少年复发性呼吸道乳头状瘤病的肺部受累似乎比目前非系统性综述所报道的更为普遍，并且在这些病例中相当一部分会在比以前报道的更年轻的年龄发生癌变。这表明应对这些儿童给予更密切的关注。我们报告一例12岁男孩的恶性转化病例，该男孩自出生起就因侵袭性青少年复发性呼吸道乳头状瘤病伴肺部受累而接受随访。通过对从转移性椎体病变获取的材料进行PCR分析，证实了人乳头瘤病毒6/11的存在。
