Matsuba H M, Thawley S E, Spector G J, Mauney M, Pikul F J
Laryngoscope. 1985 Oct;95(10):1264-6. doi: 10.1288/00005537-198510000-00023.
The speculation whether juvenile laryngeal papillomatosis may transform into or be associated with epidermoid carcinoma is explored. We document a case of invasive laryngeal carcinoma arising in preexisting juvenile laryngeal papillomatosis. After multiple childhood laryngoscopies and a tracheotomy, a 54-year-old, 30-pack per year smoker, who had never received radiation therapy, developed a florid exophytic transglottic squamous cell carcinoma. Histologically, the invasive epidermoid carcinoma was surrounded by a field of papillomata with varying degrees of atypical changes. After total laryngectomy, isolated papillomata were found in the lower trachea. There were no cervical lymph node metastases. No postoperative radiation therapy was given. Persistent squamous papillomata in the tracheostomy site, the lower trachea, and the posterior pharynx were treated with the CO2 laser. We emphasize the need to maintain a high index of suspicion for malignancy. In addition, we review the problem of benign papillomata in the aerodigestive tract following laryngectomy.
探讨了青少年喉乳头状瘤是否可能转变为表皮样癌或与之相关的问题。我们记录了一例发生于既往青少年喉乳头状瘤基础上的浸润性喉癌病例。一名54岁、每年吸烟30包且从未接受过放射治疗的患者，在经历多次儿童期喉镜检查和气管切开术后，发生了一例典型的外生性跨声门鳞状细胞癌。组织学检查显示，浸润性表皮样癌被伴有不同程度非典型改变的乳头状瘤区域所包围。全喉切除术后，在下段气管发现了孤立的乳头状瘤。无颈部淋巴结转移。未进行术后放射治疗。气管造口部位、下段气管和下咽的持续性鳞状乳头状瘤采用二氧化碳激光治疗。我们强调对恶性肿瘤保持高度怀疑的必要性。此外，我们还回顾了喉切除术后气道消化道内良性乳头状瘤的问题。
