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      Cáncer de laringe en niños: Caso clínico Translated title: Laryngeal cancer in children: Case report

      case-report

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          Abstract

          El carcinoma escamoso de laringe es muy raro en niños y adolescentes. Suele ser diagnosticado en estadios tardíos debido a los síntomas iniciales, atribuidos al proceso madurativo laríngeo o a otras enfermedades pediátricas más comunes. La visualización temprana de las cuerdas vocales con laringoscopia fexible es importante en niños que se presentan con síntomas sugestivos de patología laríngea. El diagnóstico de certeza de carcinoma lo proporciona la biopsia y el diagnóstico diferencial principal es la papilomatosis laríngea juvenil. El tratamiento constituye un desafío. No existen protocolos establecidos y se debe realizar un esfuerzo especial para preservar las funciones de la laringe y evitar complicaciones a largo plazo. Presentamos un niño de 12 años con carcinoma laríngeo invasor, sin historia previa de papilomatosis juvenil ni radioterapia, que respondió favorablemente al tratamiento con quimioterapia y radioterapia.

          Translated abstract

          Squamous cell carcinoma of the larynx is very rare in children and adolescents. It is usually diagnosed at late stages because early symptoms are often attributed to the maturation process or other common laryngeal pediatric diseases. Early visualization of vocal cords with fexible laryngoscopy is important in children presenting suggestive symptoms of laryngeal pathology. Defnitive diagnosis of carcinoma is made by biopsy, and juvenile laryngeal papillomatosis the most important differential diagnosis. Treatment constitutes a clinical challenge. There are no established protocols, and clinicians should make a special effort to preserve the functions of the larynx, and avoid long term complications. We present a 12-years-old child with invasive laryngeal carcinoma, without prior history of juvenile papillomatosis or radiotherapy, which responded favorably to chemotherapy and radiotherapy.

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          Most cited references23

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          Various forms of chemically induced liver injury and their detection by diagnostic procedures.

          A large number of chemical agents, administered for therapeutic or diagnostic purposes, can produce various types of hepatic injury by several mechanisms. Some agents are intrinsically hepatotoxic, and others produce hepatic injury only in the rare, uniquely susceptible individual. Idiosyncrasy of the host is the mechanism for most types of drug-induced hepatic injury. It may reflect allergy to the drug or a metabolic aberation of the host permitting the accumulation of hepatotoxic metabolites. The syndromes of hepatic disease produced by drugs have been classified hepatocellular, hepatocanalicular, mixed and canalicular. Measurement of serum enzyme activities has provided a powerful tool for studies of hepatotoxicity. Their measurement requires awareness of relative specificity, knowledge of the mechanisms involved, and knowledge of the relationship between known hepatotoxic states and elevated enzyme activities.
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            Laryngeal carcinoma in a 12-year-old child. Association with human papillomavirus 18 and 33.

            A laryngeal squamous cell carcinoma was observed in a 12-year-old child. There was no history of preceding papillomatosis or radiotherapy. We searched for an association with human papillomavirus (HPV). The resected specimens were assayed for infection with HPV types 11, 16, 18, 31, 33, 35, 39, 42 by in situ hybridization, and for HPV types 6, 16, 18, 33 by Southern blotting. In addition, cervical swabs of the mother were examined for HPV infection by filter in situ hybridization. Coinfection by HPV types 18 and 33 could be demonstrated by in situ hybridization, with homogeneous infection of both tumor and adjacent epithelial cells by HPV 33 and focal infection of only invasive cancer by HPV 18. Southern blot testing confirmed a high viral copy number of HPV 18 DNA. Examination of the mother at the time of tumor diagnosis revealed no evidence of HPV-related lesion in the lower genital tract. In this child, coinfection by at least two HPV types is the only evaluable risk factor for laryngeal carcinoma. Coinfection by two HPV types might substitute for carcinogenic cofactors normally present in adult laryngeal carcinomas.
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              Laryngeal Squamous Cell Carcinoma in a 13 Year-Old Child Associated with Human Papillomaviruses 16 and 18: A Case Report and Review of the Literature

              Squamous cell carcinoma (SCC) of the larynx is extremely rare in adolescents and typically has an aggressive nature. The mechanism of laryngeal oncogenesis is complex and little is known about the role that human papillomavirus (HPV) plays in SCC in adolescents. We report a case of invasive laryngeal SCC that co-expressed HPV DNA subtypes 16 and 18 in a 13 year-old boy. Detection of HPV DNA types 6, 11, 16, 18, 31, 33, and 51 was performed by in situ hybridization, with confirmation by polymerase chain reaction. Immunohistochemical staining with p16 and HPV 16/18 revealed diffusely positive staining in the tumor cells. Coinfection by HPV DNA types 16 and 18 has not been previously reported, but our case suggests that HPV is a risk factor in developing laryngeal SCC in children and adolescents. Future studies evaluating HPV in the pathogenesis of these lesions is recommended to determine its prognostic significance.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                aap
                Archivos argentinos de pediatría
                Arch. argent. pediatr.
                Sociedad Argentina de Pediatría (Buenos Aires, , Argentina )
                0325-0075
                1668-3501
                June 2012
                : 110
                : 3
                : e39-e42
                Affiliations
                [01] Buenos Aires orgnameHospital de Pediatría Prof. Dr. Juan P. Garrahan orgdiv1Servicio de Endoscopia Respiratoria
                [02] Buenos Aires orgnameFundación Arauz orgdiv1Instituto Otorrinolaringológico
                [03] Buenos Aires orgnameHospital de Clínicas José de San Martín orgdiv1Servicio de Otorrinolaringología Argentina
                Article
                S0325-00752012000300012
                37e87fba-e4d2-490d-a9a4-4f302593e764

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 16 December 2011
                : 04 November 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 0
                Product

                SciELO Argentina


                Laryngeal carcinoma,Children,Human papilloma virus,Juvenile papillomatosis,Carcinoma laríngeo,Niños,Virus del papiloma humano,Papilomatosis juvenil

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