Case 58

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical History:
The patient was a 13 year old female whose mother noted that her breathing was noisy at night when she was 4 years old. Papillomas were noted in the larynx, throat, and back of mouth. She underwent surgical and laser excision of the papillomas at 4 years of age. Chest films at that time were unremarkable. She presented again at 12 years of age with chest pain and difficulty breathing in the supine position.

Clinical Physical Exam:
Unremarkable

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Papillomatosis

Imaging Findings:
Chest films at age 12 showed multiple pulmonary lesions. Intramural masses were seen in the trachea during airway fluoroscopy. Chest CT exam better characterized the nature and extent of the pulmonary lesions.

Images 1 and 2

Images 3 and 4

Images 5 and 6

Imaging Differential Diagnosis:
Papillomatosis

Operative Findings:
Her initial surgery at 4 years of age showed papillomas in the larynx, throat, and back of mouth.

Pathological Findings:
Pathological examination of the surgical specimen from 4 years of age showed findings characteristic of papilloma.

Final Diagnosis:
Papillomatosis, Laryngeal

Follow-up and Prognosis:
Not available.

Similar Cases:
None

References:

• International Thoracic Teaching Resource - http://www.vh.org/adult/provider/radiology/ITTR/Papillomatosis/papillomatosis.html

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