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RNAscope for In situ Detection of Transcriptionally Active Human Papillomavirus in Head and Neck Squamous Cell Carcinoma
Published on: March 11, 2014
Synchronous bilateral tonsillar carcinomas associated with human papillomavirus
Susumu Nakahara1, Toshimichi Yasui1, Yukinori Takenaka1
1Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Auris, Nasus, Larynx
|July 23, 2013
Summary
Synchronous bilateral tonsillar carcinomas, a rare form of human papillomavirus (HPV)-positive oropharyngeal cancer, were successfully treated with chemoradiotherapy. This case highlights the importance of considering bilateral tonsils in HPV-positive unknown primary head and neck cancers.
Area of Science:
- Otolaryngology
- Oncology
- Virology
Background:
- The incidence of human papillomavirus (HPV)-positive oropharyngeal carcinoma is rising globally.
- Synchronous bilateral HPV-positive tonsillar carcinomas are exceptionally rare, with limited documented cases.
- Early detection and treatment are crucial for improving outcomes in head and neck cancers.
Observation:
- A 61-year-old female presented with bilateral tonsillar lesions and an enlarged cervical lymph node.
- Pathological analysis confirmed squamous cell carcinoma in tonsillar biopsies and fine needle aspirate.
- HPV-16 DNA was detected in all specimens, with concordant sequences and p16 positivity.
Findings:
- The patient was diagnosed with bilateral tonsillar carcinomas (cT1N2bM0 right, cT2N0M0 left).
- Concurrent chemoradiotherapy was administered for the synchronous lesions.
- Restaging revealed a complete response with no evidence of recurrence or metastasis at 20 months.
Implications:
- This case suggests that bilateral tonsils should be considered a potential therapeutic target in HPV-positive unknown primary head and neck cancers.
- Effective treatment with concurrent chemoradiotherapy achieved a complete response, indicating a favorable prognosis.
- Further research into the management of synchronous bilateral tonsillar malignancies is warranted.
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