Role of Human Papillomavirus and p16 Staining in a Patient With Head and Neck Cancer Presenting With a Synchronous Lung Nodule: A Case Report and Review of the Literature
Year: 2014
Type: article
Study design: Case Report
Abstract: of the Literature Case ReportA 67-year-old man with a 50 pack-year smoking history, who quit smoking 30 years before, presented complaining of dysphagia, odynophagia, hemoptysis, and a 20-pound weight loss over 3 months.A positron emission tomography/computed tomography scan showed a 2-cm, [ 18 F]fluorodeoxyglucose (FDG) -avid, left upper lobe nodule, a 3-cm FDG-avid left tonsillar mass, and a 2-cm FDG-avid left level IIa lymph node.The patient underwent a transoral biopsy that revealed squamous cell carcinoma (SCC), nonkeratinizing type, with diffuse immunohistochemical staining for p16 as well as strongly positive in situ hybridization for human papillomavirus 16 (HPV16).Fine-needle aspiration of the lung nodule was suggestive of SCC.The patient underwent a minimally invasive thoracic surgery and left upper lobe wedge resection with a level 5 mediastinal lymph node dissection.Histologic examination of the lung nodule showed a poorly differentiated SCC that was morphologically dissimilar to the tonsillar tumor (Fig 1).The tumor was 1.4 cm in largest diameter, and the margins and mediastinal lymph nodes were negative.Immunostaining for p16 was diffusely positive (Fig 2).Polymerase chain reaction (PCR) demonstrated that the tumor was negative for HPV16, HPV18, and other HPV genotypes such as 6, 11, 31, 33, 35, 45, 51, 52, 56, 58, 59, and 68.
Source: Journal of Clinical Oncology
Institutions: Mount Sinai Hospital, Tisch Cancer Institute
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2121163189