Metastasis occurring eleven years after diagnosis of human papilloma virus-related oropharyngeal squamous cell carcinoma

Abstract

Human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is associated with a favourable prognosis, although approximately 20-25% of patients ultimately develop recurrent cancer. Most disease recurrence events appear within 3 years; however, long-term follow-up of reported studies are limited, and the risk of late recurrence is unknown. We present a case report of a patient who developed distant metastases of HPV-related SCC 11 years after initial diagnosis and treatment of HPV-related OPSCC. Late disease recurrence may occur after initial diagnosis of HPV-related OPSCC. This observation has implications on the appropriate duration of follow-up and surveillance of these patients.

Keywords: human papilloma virus; oropharynx; p16.

Figure 1.. (A) Haematoxylin and eosin (H&E) stain of the neck nodal mass showing nonkeratinized squamous cell carcinoma (×200) in 2000. (B) Strong and diffuse p16 IHC stain of the tumour present in cervical lymph node from 2000.

Figure 2.. FDG-PET from 2011 showing multiple FDG avid osseous metastatic lesions.

Figure 3.. (A) Intraosseous metastasis of nonkeratinizing squamous cell carcinoma in 2011 (H&E ×100), (B) p16 IHC stain of the bone metastasis from 2011, and (C) High-risk HPV ISH of the bone metastasis from 2011 showing positive intranuclear blue stain.