Biphenotypic human papillomavirus-associated head and neck squamous cell carcinoma: a report of two cases.

Gayani Pitiyage,Edward Odell,Teresa Guererro Urbano,Mary Lei,Selvam Thavaraj

doi:10.1186/s13000-015-0334-9

Abstract

Human papillomavirus-associated oropharyngeal squamous cell carcinoma is now recognised as a subtype of head and neck cancer with distinct clinical, molecular and histological characteristics. The majority of these carcinomas are of non-keratinising squamous type but there is a growing number of histomorphologic variants of this disease. Here we describe the clinical, histomorphologic and immunophenotypic features of two cases of human papillomavirus-associated oropharyngeal squamous cell carcinoma demonstrating a clearly delineated biphasic differentiated and undifferentiated phenotype.

Highlights

Oropharyngeal squamous cell carcinoma (OpSCC) associated with high-risk subtypes of human papillomavirus (HPV) demonstrates distinct demographic and clinical characteristics
Defining the morphological diversity of HPV-associated OpSCC is necessary to determine the clinical behaviour of these possible variants
Histomorphologic and immunophenotypic features of two cases of HPV-associated OpSCC demonstrating a clearly delineated biphasic differentiated and undifferentiated phenotype

Summary

Background

Oropharyngeal squamous cell carcinoma (OpSCC) associated with high-risk subtypes of human papillomavirus (HPV) demonstrates distinct demographic and clinical characteristics. Computed tomography (CT) and 15fluoro-deoxyglucose positron emission tomographycomputed tomography (FDG-PET/CT) were undertaken to identify the primary site and revealed a 2 cm mass involving the right tonsil with a right sided level II lymph node mass extending into the deep lobe of the right parotid gland He was treated with radical chemoradiation comprising image-guided intensity modulated radiotherapy (IMRT) delivering 65Gy in 30 fractions to the oropharynx and right neck level II with 54Gy in 30 fractions to right neck levels III to V and left neck levels II to V. Case 2 A fifty-four year old male presented with an eight month history of right-sided level II neck lump He had a lifelong history of smoking 10 cigarettes a day and heavy alcohol use of 40 international units per week.

Findings

Discussion

Conclusion