A Case Study of Oral Cancer Related to Human Papilloma Virus

Abstract

Poster Presentation Background There has been an increase in the incidence of oropharyngeal cancer in women in the past 30 years that has been directly linked to human papilloma virus (HPV). Approximately 2370 new cases of oropharyngeal cancers related to HPV are diagnosed in women each year in the United States. Case A 64‐year‐old woman developed HPV‐related oropharyngeal cancer 6 years after her husband was diagnosed with the same cancer. She began experiencing pain in her left ear in January 2011 and was treated for otitis media. Her pain persisted, and by March her pain had radiated to her left jaw. A diagnosis of temporomandibular joint disorder was made by her dentist, and she was also referred for possible root canal. An magnetic resonance imaging (MRI) in June 2011 revealed an opacity in the left maxillary sinus, and the woman was treated for a sinus infection. A second MRI done in August 2011 showed no signs of infection, but her pain continued, and by September 2011 she had difficulty opening her mouth. She sought evaluation by a neurologist who treated her with pain medication and muscle relaxants. The woman's symptoms persisted until October 2012 when she noted an inability to articulate clearly and noted her tongue was deviated to the left. In November 2012 an MRI of her cranium and neck revealed a large mass of the left oropharynx. Results of a biopsy indicated T4NO squamous cell carcinoma. In January 2013, the woman began aggressive chemotherapy and radiation treatment. During the course of treatment the woman discovered that her cancer was caused by HPV. Further investigation revealed that her husband's oral cancer was caused by the same virus. This information was never reported to them at the time of his diagnosis or treatment. Conclusion Symptoms of HPV‐related oropharyngeal cancer are elusive and make early diagnosis challenging. Although rare, the transmission and eventual development of HPV‐related oropharyngeal cancer is a valid concern for intimate partners. Providing education for nurses can increase awareness in women about the possibility of developing this disease and may lead to early detection and treatment. Increased awareness of the relationship between HPV and oropharyngeal cancer can also influence the choice for HPV vaccination.