title: Suppression of respiratory papillomatosis with malignant transformation by erlotinib in a kidney transplant recipient.
abstract: A 52-year-old non-smoker and renal transplant recipient developed an incessant cough. A CT scan of the thorax revealed ill-defined hazy opacities in the right upper lung. He was diagnosed with non-tuberculosis Mycobacterium chelonae/abscessus infection based on sputum culture results. A trial of antibiotics initially resulted in some clinical improvement. A subsequent CT of the thorax documented worsening of the lesions in the right lung and new lesions on the left. An intratracheal growth was noted. Bronchoscopy with biopsy of the tracheal lesions documented respiratory papillomatosis with transformation to squamous cell cancer. Test for high-risk human papilloma virus was positive. Video-assisted thoracoscopic surgery biopsy with wedge resection of the left lower lobe revealed metastatic squamous cell lung cancer. He was treated with one ablation followed by four cycles of chemotherapy. He has been maintained on erlotinib ever since. There has been no recurrence of the cough or papillomas.
authors.affiliation: Cancer Center, Georgia Regents University, Augusta, Georgia, USA. zhao@gru.edu
authors.forename: Zhonglin
authors.initials: Z
authors.lastname: Hao
authors.forename: Thomas
authors.initials: T
authors.lastname: Dillard
authors.forename: Paul
authors.initials: P
authors.lastname: Biddinger
authors.forename: Vijay
authors.initials: V
authors.lastname: Patel
mesh_terms: D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D000069347:Erlotinib Hydrochloride; D006801:Humans; D016030:Kidney Transplantation; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride