Introduction
Recurrent Respiratory Papillomatosis (RRP) is a benign neoplasm of the
respiratory tract associated with human papillomavirus (HPV) 6 and
111. Incidence is estimated at 4.3 in 100
0002. Patients present with hoarseness1–4, signs of airway obstruction3,4, and rarely malignant transformation may
occur3. Surgical debridement is the mainstay of
symptom management. Patients often undergo multiple surgical
procedures3,4 that can result in complications such as
vocal fold scar and laryngeal stenosis5.
Several adjuvant treatment options have been proposed to decrease the
need for repeated surgical removal of tumors including intralesional
cidofovir and bevacizumab. Mohr et al, 2014 first reported good or
partial improvement with the use of systemic bevacizumab in five
patients with RRP 4. In 2016, Zur and Fox described
use of systemic bevacizumab in a 12 year old female with RRP3. In this case series we describe our experience
treating three patients with juvenile onset RRP with systemic
bevacizumab.