What's the most likely diagnosis?

• 2 year-old male with stridor

1. Enlarged adenoids
2. Enlarged tonsils
3. Papilloma
4. Croup
5. Epiglottitis

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Answer:

 

3. Laryngeal Papilloma

 

 

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Laryngeal Papillioma

General Considerations

 

• Most common benign tumor of the trachea in children (60% of all benign tumors)
• 2^nd most common benign tumor of trachea in adults
  • Majority of primary tracheal tumors are malignant
• In over 80% of cases, multiple papillomas occur in the trachea
• Tracheal papilloma is associated with a laryngeal papilloma in 36%
• Because of its high recurrence rate, it is also called Recurrent Respiratory Papillomatosis (RRP)
• Caused by the human papilloma virus (HPV)
  • Most often types 6 and 11
  • Also the cause of skin warts and genital warts
  • Transmission of recurrent respiratory papillomatosis is believed to occur, at least in part, from mother’s infected cervix during childbirth
  • HPV is responsible for most cervical cancers and about 25% of head and neck cancers
• Most common in children and then again 20-40 years of age
• Significant recurrence rate may lead to numerous operative removals
• Not the same as vocal cord polyps or nodules

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