Papillomas of the tracheobronchial tree with malignant degeneration

Solitary Endobronchial Papilloma with Malignant Transformation and Concomitant TB Infection: Case Report and Literature Review

We are reporting a case of solitary endobronchial papilloma located in posterior segment of the left upper lobe of the lung with malignant transformation and negative human papilloma virus (HPV) strains in a 40-year-old Saudi nonsmoker man. The patient had a concomitant tuberculosis (TB) infection. The patient received appropriate treatment in the form of anti-TB medication and surgical resection of the squamous cell carcinoma followed by chemotherapy. There was no evidence of tumor recurrence, resulting in a complete cure. We are reporting the case as well as a literature review related to the topic.

Coexistence of squamous cell tracheal papilloma and carcinoma treated with chemotherapy and radiotherapy: a case report

BACKGROUND

Papillomatosis presents, most frequently, as multiple lesions of the respiratory tract, which are usually considered benign. Malignant degeneration into squamous cell carcinoma is quite common, although curative approaches vary a lot in modern literature.

CASE REPORT

We report a case of a 66-year-old male patient with the coexistence of multiple squamous cell papilloma and carcinoma in the upper trachea with severe airway obstruction that was diagnosed through bronchoscopy and treated by performing an urgent tracheostomy, followed by concurrent chemotherapy and radiotherapy. There was no evidence of recurrence after a 12-month follow-up period.

CONCLUSION

This study underlines the diagnostic and therapeutic value of bronchoscopy as well as multimodality palliative treatment in such cases. To the best of our knowledge, this is the first study to describe an immediate treatment protocol with tracheostomy and concurrent chemotherapy/radiotherapy in a patient with squamous cell tracheal papilloma and carcinoma.

Malignant conversion of a solitary squamous cell papilloma in the trachea treated by radiotherapy: A case report

The present study described a rare case of malignant conversion of a solitary papilloma in the trachea, in addition to reviewing the current literature. A 54-year-old male presented with a cough, sputum and dyspnea. Chest computed tomography revealed a mediastinal soft-tissue mass in the trachea. A tumor biopsy, performed using a flexible bronchofiberscope, identified a squamous cell papilloma with moderate to severe atypical hyperplasia, as well as the formation of squamous cell carcinoma. Polymerase chain reaction analysis did not detect presence of human papilloma virus in the tumor. The patient was subsequently treated with radiotherapy and no evidence of recurrence was observed during a two-year follow-up period. To the best of our knowledge, this is the first study to describe the malignant conversion of a solitary papilloma in the trachea, which was subsequently treated with radiotherapy.

Solitary bronchial squamous cell papilloma - another human papillomavirus (HPV)-associated benign tumor: systematic review and meta-analysis

Aim of the study

To perform a systematic review and formal meta-analysis of the literature reporting on HPV detection in bronchial squamous cell papillomas (SCP).

Material and methods

The literature was searched up to June 2012. The effect size was calculated as event rate (95% CI), with homogeneity testing using Cochran's Q and I² statistics. Meta-regression was used to test the impact of study-level covariates (HPV detection method, geographic origin) on effect size, and potential publication bias was estimated using funnel plot symmetry.

Results

Fifteen studies were eligible, covering 89 bronchial SCPs from different geographic regions. Altogether, 38 (42.7%) cases tested HPV-positive; effect size 0.422 (95% CI: 0.311–0.542; fixed effects model), and 0.495 (95% CI: 0.316–0.675; random effects model). In meta-analysis stratified by i) HPV detection technique and ii) geographic study origin, the between-study heterogeneity was not significant for either; p = 0.348, and p = 0.792, respectively. In maximum likelihood meta-regression, HPV detection method (p = 0.150) and geographic origin of the study (p = 0.164) were not significant study-level covariates. Some evidence for publication bias was found only among in situ hybridization (ISH)-based studies and among studies from Europe, but with a negligible effect on summary effect size estimates. In sensitivity analysis, the meta-analytic results were robust to all one-by-one study removals.

Conclusions

In formal meta-regression, the variability in HPV detection rates reported in bronchial SCPs is not explained by the HPV detection method or geographic origin of the study.

Pathological and radiological correlation of endobronchial neoplasms: Part I, Benign tumors

Benign endobronchial lung neoplasms are extremely rare. Most such neoplasms are of mesenchymal origin; however, neoplasms of submucosal gland origin and surface epithelial origin also occur. The symptomatology and radiographic features of these tumors are often indistinguishable from those of malignant lung tumors. However, recognition and early diagnosis of these lesions may allow for conservative treatment and excellent patient outcome. The clinicopathologic and radiological features of these pulmonary neoplasms are discussed.

Endobronchial polyp and chronic smoke injury

A case of an inflammatory endobronchial polyp associated with chronic smoke injury is reported. Unlike previously reported cases, this was not associated with acute, severe thermal injury, was solitary in occurrence, and responded rapidly to a short course of intrabronchial steroids.