Successful treatment of a squamous papilloma of the hypopharynx‐esophagus by local injections of (S)‐1‐(3‐hydroxy‐2‐phosphonylmethoxypropyl)cytosine

Abstract

Human papillomaviruses (HPV) are associated with benign lesions and show specificity towards the location or tissues that they infect. HPVs are responsible for warts. Among more than 60 different HPV types known to occur in humans, a strong association has been found between types 16 and 18 and cervical cancer, and such an association is also suspected for types 31, 33, 35, 45, 51, 52, and 56. We describe the effects of (S)‐1‐(3‐hydroxy‐2‐phosphonyl‐methoxypropy Dcytosine (HPMPC), following local intratumoral injection, in a 69‐year‐old woman with hypopharyngeal and esophageal papillomatous lesions, polymerase chain reaction (PCR) positive for HPV types 16 and 18, that relapsed after surgery and that also failed to respond to Nd‐Yag laser photocoagulation and al‐pha‐interferon treatment (6 × 10⁶ U five times a week for 4 weeks followed by three times a week for 2 months). HPMPC was given at 1.25 mg/kg, with a sclerosing needle, through the biopsy channel of a video‐endoscope, directly into the tumor, from March until July 1993 at seven different occasions. The first four injections were given at an interval of 1 week at the level of the hypopharynx. The next three injections were given at an interval of 3 to 5 weeks. During the fourth to the seventh session, half of the dose was injected into the hypopharyngeal and the other half into the esophageal tumor. Three further injections of HPMPC were administered at the level of the esophageal tumor in September 1993 with 2‐week intervals. After HPMPC treatment, the lesions became smaller and flat until they completely disappeared. Endoscopic examination in February 1994 did not show any sign of papilloma in the esophagus or hypopharynx. These results suggest an in vivo efficacy of HPMPC for the treatment of papillomatous lesions due to HPV.