HPV positive oropharyngeal cancer

Abstract

### What you need to know A man in his 50s presents with a 4 week history of a lump on the right side of his neck, initially noticed while shaving. The lump was associated with a mild sore throat radiating to his right ear that persisted despite antibiotics. He is a lifelong non-smoker, who rarely drinks alcohol. On examination he had a firm, fixed 3 cm mass in the right anterior triangle, anterior to the upper third of the sternocleidomastoid muscle. Oropharyngeal exam revealed an irregularly enlarged right tonsil with a hard consistency. Squamous cell carcinoma is the most common malignancy affecting the oropharynx (fig 1), specifically the lymphoid tissue of the palatine tonsils and base of the tongue.1 The causal association between HPV, particularly the HPV 16 subtype, and oropharyngeal squamous cell carcinoma (OPSCC) was recognised by the International Agency for Research against Cancer in 2007. This is a clinically and pathologically distinct disease entity from HPV negative OPSCC. It has a markedly different epidemiology, typically affecting …