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Juvenile laryngeal papillomatosis in a pediatric population: a clinicopathologic study
G R Somers1, S N Tabrizi, A J Borg
1Department of Anatomical Pathology, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Juvenile laryngeal papillomatosis in children is highly variable. Early age of onset and human papillomavirus (HPV) status may predict disease severity and prognosis.
Area of Science:
- Pediatric Otolaryngology
- Viral Pathology
Background:
- Juvenile laryngeal papillomatosis (JLP) presents a significant clinical challenge.
- The disease course and prognosis for JLP are highly variable among affected children.
Purpose of the Study:
- To analyze the clinical course and prognostic factors of juvenile laryngeal papillomatosis.
- To investigate the role of human papillomavirus (HPV) type 6/11 in disease progression.
Main Methods:
- Retrospective review of 22 children with JLP treated over 31 years.
- Histopathological analysis and molecular detection of HPV 6/11 via in situ hybridization and PCR.
Main Results:
- Most patients diagnosed before age 5; disease duration and recurrence varied greatly.
- Recurrence rates inversely correlated with age of onset.
- HPV 6/11 detected in 20 patients; HPV-negative cases showed less aggressive disease.
Conclusions:
- Age of onset and HPV status are potential prognostic indicators for JLP.
- Histological findings did not correlate with disease severity or prognosis.
Abstract:
A series of 22 children with juvenile laryngeal papillomatosis treated over a 31-year period is presented. The majority of patients were diagnosed when less than 5 years of age. Two patients died from the disease and four patients still had active disease at the completion of the study period. The duration of disease and number of recurrences were extremely variable. The number of recurrences was inversely related to the age of onset. The histologic findings were very similar in all patients, and no particular histologic feature had prognostic significance. In 20 patients, laryngeal biopsies were positive for human papillomavirus (HPV) 6/11 by either in situ hybridization (17) or polymerase chain reaction (19) or both (16). The number of patients who were HPV negative was small (two); interestingly, neither case had aggressive disease. Our findings suggest that age of onset and HPV status may be of prognostic value in determining the clinical course of the disease.