[Pulmonary cancerization in juvenile laryngeal papillomatosis]

A case of early onset type of juvenile laryngeal papillomatosis (JLP) is reported, where pulmonary involvement developed in typical aspiration site evidenced by tuberculosis of the right lung, and which stimulated after years a squamous epithelial carcinoma. After comparison of this case with similar cases reported in the literature, the clinical feature of cancerization in JLP is discussed in the context of recent virological, immunohistochemical and pathohistological findings. The infectious nature of this disease and the reparative character of the pathologically accelerated proliferation of the papilloma epithelium are stressed, which latter is thus particularly susceptible to additional noxae: irradiation, cigarette smoke, infection and necrosis. These noxae are considered to be the ultimate cause of cancerization in JLP, especially long-standing necrosis. These noxae are considered to be the ultimate cause of cancerization in JLP, especially long-standing necrotisation of lung structures in pulmonary involvement. Surgical treatment of JLP, eradication being unconceivable, should therefore be rather conservative, and any therapeutic attendance should take utmost care to avoid intrapulmonary seeding.