Abstract
BackgroundSynchronous squamous cell carcinoma of the head and neck (HNSCC) and non-Hodgkin’s lymphoma is a rare clinical scenario. It is unknown whether the R-CHOP chemotherapy for lymphoma would also be active against HNSCC. Herein, we present such a case and a review of the literature.Case presentationA 64 year-old female presented with painless jaundice. CT demonstrated a retroperitoneal mass and pathology showed follicular lymphoma. A base-of-tongue HPV+ squamous cell carcinoma was found incidentally on staging CT. R-CHOP chemotherapy was initiated. After 3 cycles of R-CHOP the lymphoma had a complete metabolic response and, unexpectedly, the HNSCC also demonstrated excellent response. The patient received another 3 cycles followed by radiation to the HNSCC and to date is in remission for both cancers.ConclusionsThis case highlights the exquisite sensitivity of HPV-related HNSCC, which should be taken into consideration in treatment prioritization of a concurrent diagnosis of a second cancer.
Highlights
Synchronous squamous cell carcinoma of the head and neck (HNSCC) and non-Hodgkin’s lymphoma is a rare clinical scenario
This case highlights the exquisite sensitivity of human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC), which should be taken into consideration in treatment prioritization of a concurrent diagnosis of a second cancer
We review the literature and cite other cases of synchronous Squamous cell carcinoma (SCC) of aerodigestive tract and lymphoma treated with upfront R-CHOP chemotherapy, with a discussion of possible mechanisms of how component(s) of R-CHOP chemotherapy led to the regression of SCC
Summary
We report a case of synchronous retroperitoneal follicular lymphoma and HPV+ BOT HNSCC in a 64 year-old female patient in which HNSCC had an excellent response to R-CHOP chemotherapy before definitive chemoradiation therapy. Abbreviations 5-FU: 5-fluorouracil; BOT: Base of tongue; CABO: Cisplatin, methotrexate, bleomycin and vincristine; cCR: Complete clinical response; CRT: Concurrent chemoradiation; CT: Computed tomography; EGFR: Epidermal growth factor receptor; HNSCC: Squamous cell carcinoma of the head and neck; HPV: Human papillomavirus; NSTEMI: non-ST-elevation myocardial infarction; OPC: Oropharyngeal cancer; PET/CT: Positron emission tomography/ computed tomography; R-CHOP: Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; RT: Radiation therapy; SCC: Squamous cell carcinoma; SPC: Second primary cancer. Author details 1Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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