Head and Neck Tumors
The diagnostic value of HPV detection in squamous cell carcinoma of cervical lymph node metastasis from an unknown primary site (with report of 6 cases)
Jiang Chenxue, Xu Tingting, Wang Cuihong, Sun Guohua, Wang Qifeng, Shen Chunying, Hu Chaosu, Lu Xueguan
Published 2020-04-15
Cite as Chin J Radiat Oncol, 2020,29(04): 259-261. DOI: 10.3760/cma.j.cn113030-20190304-00002
Abstract
ObjectiveTo evaluate the diagnostic value of HPV detection in squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site.
MethodsClinical data of 6 patients who were initially diagnosed with squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site and eventually diagnosed with HPV-related oropharyngeal squamous cell carcinoma were collected, and the process of diagnosis was analyzed.
ResultsUpon the initial admission, all patients were diagnosed with squamous cell carcinoma of the cervical lymph node metastasis with positive p16 expression, positive HPV-16 subtype and negative EBER expression. No obvious primary lesion was found after comprehensive examination. Subsequently, four of them underwent ipsilateral tonsollar blind biopsy (n=2) and ipsilateral tonsillectomy (n=2). All these four patients were pathologically diagnosed with tonsillar squamous cell carcinoma. For the other two cases, MRI detected the thickening complicated with enhancement of ipsilateral wall of oropharynx and tongue root after follow-up for D149 and D545 , respectively. Biopsy confirmed the diagnosis of squamous cell carcinoma of the tonsil and tongue root, respectively.
ConclusionFor patients with HPV-positive squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site, the possibility that the primary lesion originates from the oropharyngeal site, especially the tonsil and tongue root, should be highly suspected.
Key words:
Neoplasm, cervical lymph node metastasis; Human papillomavirus; p16; Oropharyngeal carcinoma
Contributor Information
Jiang Chenxue
Departmentof Radiation Oncology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Xu Tingting
Departmentof Radiation Oncology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Wang Cuihong
Department of Radiology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Sun Guohua
Department of Surgery of Head & NeckFudan University Shanghai Cancer Center, Shanghai 200032, China
Wang Qifeng
Department of Pathology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Shen Chunying
Departmentof Radiation Oncology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Hu Chaosu
Departmentof Radiation Oncology Fudan University Shanghai Cancer Center, Shanghai 200032, China
Lu Xueguan
Departmentof Radiation Oncology Fudan University Shanghai Cancer Center, Shanghai 200032, China
