Oropharyngeal Carcinoma Presenting as a Large Cervical Mass With Impending Airway Obstruction

A middle-aged woman presented with progressive pharyngeal symptoms and an enlarging neck mass, eventually diagnosed as human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC). Due to impending airway obstruction, an emergency tracheostomy was performed. Histopathological examination confirmed squamous cell carcinoma, leading to a final diagnosis of non-HPV-associated OPSCC, a rarer and more aggressive subtype. Despite receiving palliative radiotherapy for symptom control, the disease progressed aggressively, and the patient was ultimately transitioned to best supportive care. OPSCC arises from the mucosal epithelium of the oropharynx. Early symptoms such as persistent throat discomfort, dysphagia, and cervical lymphadenopathy are relatively characteristic of oropharyngeal tumors. Tumor progression can cause critical airway obstruction depending on the lesion's size and location. In this report, we present a case of OPSCC that required emergency airway management due to the risk of airway obstruction. This case underscores the importance of early diagnosis and airway management in patients with progressive pharyngeal symptoms and high-risk features.