We present the case of a 47-year-old male known for COPD who developed an 8-month history of nonproductive cough and dyspnea. CT scan showed a mass on the distal trachea and left main bronchus projecting into the lumen, thus resulting in a partial atelectasis of the left lower lobe. Bronchoscopy revealed an exophytic lesion arising from the mucosa of the distal trachea and the left main bronchus almost completely occluding the latter. Rigid bronchoscopy was performed for debulking and allowed complete recanalization of the left main bronchus. Pathology and microbiology results were compatible with endoluminal papillomatosis caused by human papilloma virus 11 (HPV11). At 3 months’ follow up, recurrence was visible; intralesional injection of cidofovir was therefore performed, allowing substantial regression of the lesions at 18 months’ follow up (Fig. 1).
The term recurrent respiratory papillomatosis (RRP) describes the presence of papillomas involving the respiratory epithelium.1,2 Although benign, disease course is often characterized by recurrence of lesions and risk for airway compromise. No curative therapy is available; surgery therefore remains the mainstay for treatment. However, adjunctive pharmacological treatment, in particular with intralesional cidofovir, can decrease the need for repeated surgical intervention and has even demonstrated complete regression of papillomas.1
