Rxe9;sumxe9;
La transformation maligne d’une papillomatose laryng
xe9;e juv
xe9;nile est rare et les cas rapport
xe9;s ont
xe9;t
xe9; essentiellement o
bserv
xe9;s chez l’adulte. Nous rapportons le cas d’une enfant de 15 ans d
xe9;c
xe9;d
xe9;e d’un cancer
bronchopulmonaire avec envahissement p
xe9;ricardique d
xe9;
velopp
xe9;
xe0; partir d’une papillomatose laryng
xe9;e juv
xe9;nile. Un papillomavirus humain (HPV) de type 11 a
xe9;t
xe9; identifi
xe9; dans les papillomes nasopharyng
xe9;s et trach
xe9;aux ainsi que dans le liquide p
xe9;ricardique. Le s
xe9;quen
xe7;age des g
xe8;nes
E1, E2, E4, E6 et E7 de HPV 11, ainsi que le s
xe9;quen
xe7;age des exons 5
xe0; 9 du g
xe8;ne de la prot
xe9;ine P53 de cette adolescente n’ont pas permis d’identifier de mutations pouvant
xea;tre associ
xe9;es
xe0; cette transformation maligne. Cette o
bservation confirme que la transformation maligne d’une papillomatose laryng
xe9;e juv
xe9;nile peut survenir chez l’enfant. Le rôle carcinog
xe8;ne de HPV 11 dans ce contexte reste encore
xe0;
xe9;lucider.
Summary
Malignant transformation of juvenile-onset recurrent respiratory papillomatosis (RRP) is a rare event and the cases reported have been mainly observed in adults. We report the case of a 15-year-old girl with a history of severe RRP who died of a HPV 11-associated bronchopulmonary squamous cell carcinoma with pericardial invasion. HPV 11 was identified in nasopharyngeal and tracheal papillomas, as well as in the pericardial fluid. HPV 11 isolate was further analyzed by amplification and sequencing of the E1, E2, E4, E6, and E7 genes. Only one amino acid substitution in E4 due to natural polymorphism was observed. Exons 5–9 of the patient's tumor protein 53 (TP53) gene were sequenced and no mutations were identified. This observation confirms that malignant conversion of juvenile-onset RRP associated with HPV 11 to squamous cell carcinoma may arise in children. HPV 11-induced carcinogenesis needs to be further investigated.