title: Rare case of malignant transformation of recurrent respiratory papillomatosis associated with human papillomavirus type 6 infection and p53 overexpression.
abstract: Recurrent respiratory papillomatosis (RRP), a chronic upper respiratory condition characterized by diffuse multiple recurring papillomas, is thought to result from human papillomavirus (HPV) type 6 or 11 infection. Although RRP is an intractable disease, malignant transformation of RRP is rare. The underlying mechanism, however, has not been elucidated. We describe the clinical course of a patient who underwent more than 130 operations for RRP associated with HPV type 6 infection and subsequently suffered spontaneous malignant transformation to squamous cell carcinoma. Immunohistochemical analysis revealed that malignant transformation might result from a genomic defect, such as p53 inactivation, leading to stimulation of uncontrolled cell proliferation by HPV type 6 for an extended period, but not directly because of HPV itself. Our results could help in the development of novel therapeutic strategies for severe RRP, although further studies are required before clinical application of molecular targeted therapies.
authors: Department of Otolaryngology/Head and Neck Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan.
authors: Takeharu
authors: T
authors: Kanazawa
authors: Noriyoshi
authors: N
authors: Fukushima
authors: Shoichiro
authors: S
authors: Imayoshi
authors: Takafumi
authors: T
authors: Nagatomo
authors: Kazumi
authors: K
authors: Kawada
authors: Hiroshi
authors: H
authors: Nishino
authors: Kiyoshi
authors: K
authors: Misawa
authors: Keiichi
authors: K
authors: Ichimura
keywords: Human papillomavirus; Immunohistochemistry; Malignant transformation; Recurrent respiratory papillomatosis; p53
references: Acta Otolaryngol Suppl. 1997;527:100-2
references: 9197493
references: Laryngoscope. 1998 May;108(5):735-40
references: 9591556
references: Laryngoscope. 2004 Nov;114(11):1906-9
references: 15510012
references: Eur Arch Otorhinolaryngol. 2000;257(5):263-9
references: 10923940
references: Biochem Pharmacol. 2010 Dec 15;80(12):1930-5
references: 20643111
references: Am J Otolaryngol. 2010 Jul-Aug;31(4):291-6
references: 20015762
references: Acta Otolaryngol. 2007 Nov;127(11):1196-201
references: 17851940
references: Head Neck. 2009 Aug;31(8):1095-101
references: 19072996
references: Otolaryngol Head Neck Surg. 2011 Feb;144(2):252-6
references: 21493426
references: Mol Med. 2012 Mar 30;18:244-9
references: 22113496
references: Otolaryngol Head Neck Surg. 2005 Mar;132(3):392-4
references: 15746849
references: Pharmacotherapy. 2005 Jul;25(7):977-89
references: 16006276
references: Case Rep Oncol. 2011 Mar 23;4(1):162-71
references: 21526134
references: Antiviral Res. 2000 Feb;45(2):83-93
references: 10809017
references: Mol Med. 2007 Mar-Apr;13(3-4):143-50
references: 17592548
references: Otolaryngol Head Neck Surg. 2000 Mar;122(3):378-86
references: 10699815
references: Expert Opin Pharmacother. 2009 Mar;10(4):645-55
references: 19284366
references: Ann Otol Rhinol Laryngol. 2003 Apr;112(4):298-302
references: 12731623