TÇCD 2011 29. National Pediatric Surgery Congress and 27. National Congress of The Egyptian Pediatric Surgical Association

Respiratory papillomatosis in children is a rare disease with an incidence of 4.3 / 100 000 children. To the best of our knowledge there is no reported case ofrespiratory papillomatosis in literaturearising in the trachea without laryngeal involvement. Due to its interesting nature we present a case of respiratory papillomatosis arising in the trachea and lungs, with its similar clinical and radiological features often misdiagnosing as asthma.

A 15-years-old boy admitted to emergency department in severe respiratory distress. He had been suffering from coughing, wheezing breathing and exercise-induced asthma episodes since last 3 months, the symptoms having gradually worsened over the recent weeks. He had diagnosed as asthma with recurrent bronchitis, and despite treatment with inhaled bronchodilators and steroids, his symptoms worsened. Cysts in the lung tissue were detected by chest X-ray. Computerized tomography (CT) of the chest revealed an intraluminal tumor arising from the right side of the trachea, confirming the presence of cysts in the lung tissue with typical appearance of chronic pulmonary diseases. Bronchoscopy performed under general anesthesia demonstrated a spherical and irregular-surfaced mass attached to the tracheal wall through a narrow pedicle occluding about 70% of the lumen. The tumor was removed completely with biopsy forceps. Pathologic examination of the specimens revealed a squamous cell papilloma.

We present this case to emphasize that in patients with persistent asthma-like symptoms chest CT should be performed and when cyst-like changes are present presence of respiratory papillomatosis should be considered in differential diagnosis.