EFFECT OF PHOTODYNAMIC THERAPY AND EXTERNAL BEAM RADIATION-THERAPY ON JUVENILE LARYNGOTRACHEOBRONCHIAL PAPILLOMATOSIS

Treatment of juvenile laryngotracheobronchial papillomatosis is currently unsatisfactory and typically involves frequent endoscopic removal of the lesion with cup forceps and laser therapy. Malignant transformation of these lesions is a known complication. A case is reported of an adult patient with persistent juvenile laryngotracheobronchial papillomatosis who developed carcinoma in situ of the trachea and right upper lobe bronchus. He underwent experimental photodynamic therapy using dihematoporphyrin ether and rhodamine B dye laser. In addition, he recevied external beam radiation therapy. Bronchoscopy revealed no evidence of carcinoma in situ or recurrence of the underlying papillomas for a follow-up period of 24 months. This observation suggests that photodynamic therapy with dihematoporphyrin ether, either alone or in combination with radiation therapy, may have a role in the ablation of juvenile laryngotracheobronchial papillomatosis.