Recurrent respiratory papillomatosis is caused by human papillomavirus. This tumor is most often diagnosed when it occurs in the voice box as laryngeal papillomas. Although laryngeal papillomas can occur at any age, they most commonly affect children aged 1 to 4 years.
Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas reappear often and occasionally spread into the windpipe (trachea) and lungs, blocking the airway. Rarely, they become cancerous (malignant).
Although some tumors may begin to disappear at puberty, treatment of recurrent respiratory papillomatosis is recommended. Surgical removal is the usual treatment. Many children require numerous procedures throughout childhood to remove the tumors as they reappear.
Other treatments (such as pulsed-dye laser therapy or photodynamic therapy—see Using Lasers to Treat Skin Problems) as well as an antiviral drug (cidofovir) or a drug that is used to treat cancer (bevacizumab) may be given to children who have a severe case.