Successful Use of Argon Plasma Coagulation in the Treatment of Multiple Recurrent Lower Tract Papillomatosis: A Case Report

Recurrent Respiratory Papillomatosis is a rare, benign papillomatous growth of the bronchial epithelium which occurs in 18 patients in a million. Due to the rareness of the disease, no general treatment consensus exists. Surgical debulking or simple excision via bronchoscopy are the most used therapeutic approaches with adjunct medical therapy, such as intra-lesional antivirals and interferon therapy, in case of recurring disease. We present the case of a 51-year-old man who presented with recurrent respiratory papillomatosis. This case made the approach more challenging as we were dealing with widespread isolated lower respiratory tract involvement (lower trachea and main bronchi) sparing the larynx and vocal cords without evidence of HPV virus infection. A decision was made to intervene with bronchoscopic electro snare and argon plasma coagulation (APC) as few reported cases highlighted the effectiveness of APCs in the treatment of Recurrent Respiratory Papillomatosis with the patients remaining lesion-free in the 5 months follow up. Moreover, its safety and low risk of perforation/cartilage damage along with its efficiency when it comes to multiple lesions in critical sites established its important role as a therapeutic option.