A case report of recurrent respiratory papillomatosis progressed into a loco-regionally advanced laryngeal carcinoma

polymerase chain reaction (PCR) detected HPV type 11. The patient had never been treated with adjuvant therapies available for this disease: quadrivalent HPV (types 6/11/16/18), Cidofovir or other adjuvant therapies. Patient smoked one pack a day for 16 years. Mother’s patient died of larynx cancer ten years ago. At the age of 34 years, the patient returns for recurrence of dysphonia. An endoscopy revealed large papillomas growth in the glottic area. The neck CT-scan with contrast agent showed a large mass at the right true vocal cord, extended to the right Morgagni ventricle, right false vocal cord, right arytenoid, subglottic level and to the paraglottic space (Fig. 1). A larynx biopsy was performed. The histopathological examination showed the transformation to squamous cell carcinoma. The classification for malignant tumor was T4aN0M0. The patient received 3 cycles x TPF (drugs in the Cisplatin-Taxotere-5 Fluorouracil combination) induction chemotherapy, according to the Oncologic Committee’s decision, and a partial remission of tumor was obtained. The assessment was made in the third week after the third cycle of chemotherapy through the endoscopy examination and neck CT-scan with contrast agent (Fig. 2). After one months from chemotherapy, the patient was submitted to total laryngectomy with total thyroidectomy and bilateral selective neck dissection, at the Ear, Nose and Throat Department of the Emergency County Hospital of Cluj-Napoca, in May 2014. Voice restorations was obtained with Traheoesophageal voice prosthesis (TEP). Postoperative the patient was submitted to adjuvant radiotherapy (dose of 60 Gy). Presently, at one year after total laryngectomy the disease remains stable without recurrence. Postoperative follow up is made by clinical examination and neck CT-scan. The patient is well and has resumed normal daily activities. Patient no longer smokes. Abstract. In this article, we present the clinical course of a patient who had more than 30 operations for recurrent laryngeal papillomatosis associated with HPV type 11 infection, and who was diagnosed with a laryngeal squamous cell carcinoma at the age of 34 years. Other risk factors such as smoking or hereditary tendency to malignant tumors were associate in this case. It is known that Recurrent respiratory papillomatosis (RRP) has the potential to suffer malignant transformation. The risk of cancer must be considered in all cases of laryngeal papillomatosis, requiring special attention especially in cases with multiple relapses.