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Review
. 2009 Mar;3(1):78-81.
doi: 10.1007/s12105-009-0100-y. Epub 2009 Feb 24.

The changing face of head and neck cancer in the 21st century: the impact of HPV on the epidemiology and pathology of oral cancer

William H Westra  1
Affiliations
Review

The changing face of head and neck cancer in the 21st century: the impact of HPV on the epidemiology and pathology of oral cancer

William H Westra. Head Neck Pathol. 2009 Mar.

Abstract

The longstanding notion that head and neck squamous cell carcinoma (HNSCC) is a uniform disease process is changing. Divergence in epidemiologic trends among HNSCCs arising in different anatomic subsites has introduced a view that HNSCC is a heterogeneous group. Analysis of molecular genetic changes discloses not just individual tumor differences, but also consistent large-scale differences that permit the recognition of important tumor subtypes. One recently recognized subtype is the human papillomavirus (HPV)-positive oropharyngeal carcinoma. HPV-positive oropharyngeal cancer now dominates the head and neck oncology landscape, and its escalating incidence is impacting on diagnostic, preventive and therapeutic practices.

Keywords: Head and neck squamous cell carcinoma; Human papillomavirus; In situ hybridization; Oral cancer.

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Figures

Fig. 1
Fig. 1
Typical histopathologic appearance of an HPV-related cancer of the head and neck. a The carcinomas tend to arise from the tonsillar crypts and infiltrate the lymphoid stroma as expanding tumor lobules. b The lobules of tumor cells are permeated by lymphocytes, lack keratinization, and have a basaloid appearance
Fig. 2
Fig. 2
Metastatic squamous cell carcinoma of unknown primary origin. The metastasis is cystic (a, hematoxylin and eosin). The presence of HPV as evident by p16 immunohistochemical staining (b) and HPV-16 in situ hybridization (hybridization dots within tumor cell nuclei, inset) point to the oropharynx as the site of tumor origin
See this image and copyright information in PMC

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