Juvenile laryngeal papillomatosis with pulmonary parenchymal spread. Case report and review of the literature.

A 6.5-year-old boy developed laryngeal papillomas at 20 months of age and pulmonary parenchymal spread at age 3.5 years, the lung lesions beginning as solid nodules which rapidly cavitated. The cavitary lesions have stabilized in size but no appreciable improvement has resulted from trials of bleomycin, methotrexate, or interferon. A review of 14 other cases indicates that the lung lesions may develop many years after the onset of laryngeal papillomatosis, and the lung lesions do not tend to regress spontaneously as uncomplicated juvenile laryngeal papillomas often do. Three of 15 patients developed carcinomas in their lung lesions without prior therapeutic irradiation.