A Case Series of Therapeutic Outcomes of Head and Neck Cancer Patients with Unnoticed HIV Infection

Abstract

Background: Immune suppression secondary to Human Immunodeficiency Virus (HIV) infection is associated with an increased risk of head and neck cancer (HNC) and poorer tumor-related survival. In this article, the authors focused on the outcome of a specific subgroup of HIV-HNC patients with undetectable HIV load at cancer diagnosis. Case Presentation: We report of 4 HIV patients with head and neck cancer. The first patient showed an incidental finding of synchronous papillary thyroid carcinoma in the cervical lymph nodes after neck dissection. The second patient developed multiple local and regional recurrences of a nasal carcinoma. The third patient could not receive treatment for nasopharyngeal carcinoma due to multiple comorbidities. The fourth patient showed a long disease free survival after aggressive treatment of an oropharyngeal carcinoma. The patients reported developed synchronous HNC and local recurrences. Moreover, local control was not always easy to achieve. Multiple comorbidities, psychological factors and complications often led to treatment delay. Conclusions: The authors suggest consideration of early aggressive treatment and intensive follow up for HIV-HNC patients despite undetectable HIV load; since other parameters, such as immunosuppression, inflammation and direct viral oncogenic effect, could have already accelerate the natural course of the disease and affect the outcome.