2017 Volume 120 Issue 6 Pages 841-846
There have been several reports of synchronous HPV-associated tonsillar carcinomas, however, there are no reports until date of synchronous HPV-associated carcinomas arising in the oropharynx and nasal cavity. Herein, we report the case of a 64-year-old man with synchronous HPV-positive SCCs of the tonsil and nasal cavity.
A 64-year-old man presented with pain in the throat on swallowing. He also had 3-year history of excessive lacrimation. Initial CT imaging showed masses in the right tonsil and right nasal cavity. PET-CT revealed no evidence of lymph node metastasis or distant metastasis. Biopsies of the right tonsillar tumor and right nasal cavity revealed poorly differentiated carcinoma at both sites. Immunohistochemistry revealed positive staining for p16 in both the right tonsillar and right nasal cavity carcinomas. Evidence of HPV infection was searched for using multiplex-PCR. HPV-16 and HPV-45 were detected from the right tonsillar tumor, and HPV-59 from the right nasal cavity tumor. The right tonsillar tumor was classified as T3N0M0, and the right nasal cavity tumor as T4aN0M0. After complete staging, the patient received concomitant weekly cisplatin plus radiotherapy at a total dose of 70 Gy. Both tumors responded well to chemoradiotherapy, and at the follow-up conducted 2 years after completion of the chemoradiation therapy, there was no evidence of recurrence or metastasis.
