Isotretinoin therapy for recurrent respiratory papillomatosis.
Retinoic acid has been advocated for use in several premalignant and malignant epithelial lesions of the head and neck, including benign recurrent respiratory papillomatosis, with varying results. We describe a 24-year-old man with extensive tracheoesophageal and bronchoalveolar papillomatosis that degenerated into squamous cell carcinoma. Multiple endoscopic carbon dioxide laser excisions, at one point performed on a weekly basis, as well as a prolonged trial of interferon, failed to control the progression of his disease. Isotretinoin (13-cis-retinoic acid) therapy (1 mg/kg per day) was instituted, with dramatic clinical, radiographic, and functional improvement. The patient experienced no significant toxic effects and required no endoscopic procedures over a 6-month period. We propose that isotretinoin may be an effective adjuvant therapy for aggressive respiratory papillomatosis.
Eicher
S A
SA
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex.
Taylor-Cooley
L D
LD
Donovan
D T
DT
D000284:Administration, Oral; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D010212:Papilloma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D011859:Radiography; D012142:Respiratory Tract Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology
D015474:Isotretinoin