A Nicaraguan woman with no relevant disease history presented with sudden onset dyspnea, laryngeal stridor and basal SatO2 75%. Urgent laryngoscopy evidenced an exophytic mass of soft consistency. Orotracheal intubation under videolaryngoscopic (C-MAC®) guidance was performed, displacing the mass with the orotracheal tube, without incidents. At subsequent surgery, multiple supra- and subglottic papillomatous implants were removed (Fig. 1), with posterior good airway patency (Fig. 2). Evaluation of esophageal and bronchial tree spread proved negative. The diagnosis was confirmed by the subsequent histopathological study (Fig. 3).

Figure 1

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Figure 2

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Figure 3

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Laryngeal papillomatosis is a rare disorder caused by the human papillomavirus (HPV), producing severe respiratory failure. Urgent surgery is indicated, and the prognosis is good – though recurrences are frequent. In the event of recurrence, repeat surgery combined with immune-modulating therapy such as intralesional interferon, should be considered.