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Clinical features of malignant transformation in benign laryngeal papillomata

Published online by Cambridge University Press:  29 June 2007

Bharath Singh*
Affiliation:
Department of Otolaryngology, University of Natal, South Africa
Reena Ramsaroop
Affiliation:
Department of Otolaryngology, University of Natal, South Africa
*
B.Singh, Department of Otolaryngology, Faculty of Medicine, University of Natal, PO Box 17039, Congella 4013, South Africa..

Abstract

Laryngeal papillomata can undergo spontaneous malignant transformation without being detected histologically and, in some instances, the disease may become so advanced, before the diagnosis is confirmed, that it is beyond any form of curative treatment.

Because of this limitation imposed by histopathological investigation, a study was undertaken in 17 adults with benign laryngeal papillomata, (three of whom underwent malignant transformation) to determine whether malignant transformation can be predicted from the clinical behaviour of the tumour. The following features were analysed: age, sex, patient's symptoms, frequency of excision of the papillomata, site of lesion, presence or absence of laryngeal oedema, the need for tracheostomy, vocal fold mobility and presence or absence of cervical lymph nodes.

It was found that decreased vocal fold mobility, the presence of cervical lymph nodes, exuberant and rapid growth requiring very frequent excisions, oedema of the larynx with airway obstruction requiring a tracheostomy are clinical features suggestive of malignant transformation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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References

Bewtra, C., Krishnan, R., Lee, S. A. (1982) Malignant changes in nonirradiated juvenile laryngotracheal papillomatosis. Archives of Otolaryngology 108: 114116.CrossRefGoogle ScholarPubMed
Bjelkenkrantz, K., Olofsson, J., Stal, O., Grontoft, O. (1983) Juvenile laryngeal papilloma: histologic and photometric evaluation of atypia. Laryngoscope 93: 468474.CrossRefGoogle ScholarPubMed
Cohen, S. R., Geller, K. A., Seltzer, S., Thompson, J. W. (1980) Papilloma of the larynx and tracheobronchial tree in children. A retrospective study. Annals of Otology, Rhinology and Laryngology 89: 497503.CrossRefGoogle ScholarPubMed
Fechner, R. E., Geopfert, H., Alford, B. R. (1974) Invasive laryngeal papillomatosis. Archives of Otolaryngology 99: 147151.CrossRefGoogle ScholarPubMed
Galloway, T. C., Soper, G. R., Elsen, J. (1960) Carcinoma of the larynx after irradiation of papilloma. Archives of Otolaryngology 72: 289294.CrossRefGoogle ScholarPubMed
Kashima, H., Wu, T., Mounts, P., Heffner, D., Cachay, A., Hyams, V. (1988) Carcinoma ex-papilloma: histologic and virologic studies in whole-organ sections of the larynx. Laryngoscope 98: 619624.CrossRefGoogle ScholarPubMed
Keim, R. J. (1980) Malignant change of laryngeal papillomas: a case report. Otolaryngology-Head and Neck Surgery 88: 737777.CrossRefGoogle ScholarPubMed
Le Jeune, F. E. (1941) The story of Warren Bell. Annals of Otology, Rhinology and Laryngology 50: 905908.CrossRefGoogle Scholar
Lim, R. Y., Chang, H. (1987) Malignant degeneration of a laryngeal papilloma. Otolaryngology-Head and Neck Surgery 96: 559561.Google Scholar
Matsuba, H. M., Thawley, S. E., Spector, G. J., Mauney, M., Pikul, F. J. (1985) Laryngeal epidermoid carcinoma associated with juvenile laryngeal papillomatosis. Laryngoscope 95: 12641266.CrossRefGoogle ScholarPubMed
McCart, H. (1954) Tracheal and bronchial implant showing malignant changes. Annals of Otology, Rhinology and Laryngology 63: 498499.CrossRefGoogle ScholarPubMed
Olofsson, J., Bjelkenkrantz, K., Grontoft, O. (1980) Malignant degeneration of a juvenile laryngeal papilloma – a follow-up study. Journal of Otolaryngology 9: 329333.Google ScholarPubMed
Quick, C. A., Foucar, E., Dehner, L. P. (1979) Frequency and significance of epithelial atypia in laryngeal papillomatosis. Laryngoscope 89: 550560.CrossRefGoogle ScholarPubMed
Rabbett, W. F. (1965) Juvenile laryngeal papillomatosis. The relationship of irradiation to malignant degeneration in this disease. Annals of Otology, Rhinology and Laryngology 74: 11491163.CrossRefGoogle Scholar
Robbins, K. T., Howard, D. (1983) Multiple laryngeal papillomatosis requiring laryngectomy. Archives of Otolaryngology 109: 765769.CrossRefGoogle ScholarPubMed
Shapiro, R. S., Marlowe, F. I., Butcher, J. (1976) Malignant degeneration of non-irradiated juvenile laryngeal papillomatosis. Annals of Otology, Rhinology and Laryngology 85: 101104.CrossRefGoogle Scholar
Siegel, S. E., Cohen, S. R., Isaacs, H., Stanley, P. (1979) Malignant transformation of tracheobronchial juvenile papillomatosis without prior radiotherapy. Annals of Otology, Rhinology and Laryngology 88: 192197.CrossRefGoogle ScholarPubMed
Toso, G. (1971) Epithelial papillomas – benign or malignant? Laryngoscope 81: 15241531.CrossRefGoogle ScholarPubMed
Walsh, T. E., Beamer, P. R. (1950) Epidermoid carcinoma of the larynx occurring in two children with papilloma of the larynx. Laryngoscope 60: 11101124.CrossRefGoogle ScholarPubMed
Yoder, M. G., Batsakis, J. G. (1980) Squamous cell carcinoma in solitary laryngeal papilloma. Otolaryngology-Head and Neck Surgery 88: 745748.CrossRefGoogle ScholarPubMed
Zehnder, P. R., Lyons, G. D. (1975) Carcinoma and juvenile papillomatosis. Annals of Otology, Rhinology and Laryngology 84: 614618.CrossRefGoogle ScholarPubMed