CTICasesRecurrent Respiratory Papillomatosis with Malignant Transformation to Squamous Cell Carcinoma
Imaging findings
Tracheobronchial imaging and laryngoscopy show multiple small, mobile papillomas clustered in the proximal airway. Over a multi-year period, the patient developed thin-walled cystic and solid nodular parenchymal lung lesions, with one left lung nodule transforming into a massive, solid squamous cell carcinoma requiring a pneumonectomy. Post-procedural imaging following laser debridement reveals a large hemopneumothorax with pleural adhesions, as well as a posterior tracheal tear with surrounding gas and a mediastinal hematoma.
Key takeaways
Recurrent respiratory papillomatosis is a benign neoplastic disease caused by human papillomavirus that rarely disseminates into the lung parenchyma to form thin-walled cysts and nodules. Squamous cell carcinoma transformation of these parenchymal lesions is a known long-term risk. Additionally, therapeutic interventions like laser ablation can cause serious immediate iatrogenic complications, including airway laceration, mediastinal hemorrhage, and pneumothorax.
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