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Rare case of p16-positive oropharyngeal cancer metastasis to the orbit
Chaithanya Jeganathan1, Jian Li Tan2,3, Chris Dhepnorrarat2
1Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia chaithanyajeganathan@gmail.com.
Abstract:
We describe a case of a man in his 70s who was diagnosed with a p16-positive base of tongue squamous cell carcinoma (SCC) and presented with deteriorating vision and exophthalmos. Imaging revealed medial rectus hypertrophy, and surgery confirmed metastatic p16-positive SCC. Literature reveals that orbital metastasis from any malignancy is a rare occurrence, and even that of p16-positive oropharyngeal SCC has only been reported once in English literature previously. The case highlights the importance of maintaining a wide differential and not being narrowed into a diagnosis or treatment, and given the increasing incidence of human papillomavirus-related cancers, it is important to preserve a high index of suspicion.
Insights
A rare case of p16-positive base of tongue squamous cell carcinoma (SCC) metastasizing to the orbit is presented. This highlights the importance of considering orbital metastasis in patients with human papillomavirus-related cancers.
Area of Science:
- Oncology
- Ophthalmology
- Head and Neck Surgery
Background:
- Squamous cell carcinoma (SCC) of the base of the tongue is a significant head and neck malignancy.
- Orbital metastasis from primary cancers is exceptionally rare, posing diagnostic challenges.
Observation:
- A male patient in his 70s with p16-positive base of tongue SCC presented with vision loss and exophthalmos.
- Ophthalmological examination revealed medial rectus hypertrophy, suggestive of an orbital mass.
Findings:
- Surgical exploration confirmed metastatic p16-positive SCC within the orbit.
- This represents a rare instance of orbital metastasis from oropharyngeal SCC, with limited prior reports.
Implications:
- The case underscores the necessity of a broad differential diagnosis in cases of unexplained visual disturbances and proptosis.
- Increased incidence of human papillomavirus-related cancers warrants a high index of suspicion for unusual metastatic patterns.
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