HPV-related cervical disease and oropharyngeal cancer

Abstract

Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervical and oral cancer. We show the case of a woman affected by HPV-related cervical disease and oropharyngeal squamous cell carcinoma (OPSCC). A 41-year-old woman arrived at our Colposcopy Center following an abnormal Pap smear result (ASC-H) and a diagnosis of moderate cervical dysplasia obtained by a cervical biopsy. She underwent a colposcopy that showed a cervical abnormal transformation zone grade 2. A laser conization was performed in November 2010. Histology reported a moderate/severe dysplasia. The cone resection margins were free. Follow-up colposcopy and cytology were negative. The HPV testing showed an infection by HPV 16. In October 2012, the patient presented to the Head-Neck ER after episodes of hemoptysis; a lesion was found in the left tonsillar lodge. A biopsy was performed with a result of squamous cell carcinoma with low-grade differentiation. The HPV testing detected a high-risk HPV and the immunohistochemical analysis was positive for p16. She was treated by chemotherapy and brachytherapy. She was followed at the head-neck center with monthly visits with oral visual inspection that showed complete absence of mucosal abnormalities. HPV-related OPSCC and cervical precancerous/cancerous lesions have significant similarities in terms of pathogenesis. They are both caused largely by HPV 16, as in the present case. In conclusion, because of this association found in literature and in our case, we think that women with HPV cervical lesions should have regular surveillance for oropharyngeal cancer, whereas women with OPSCC should be encouraged to have diligent cervical screening.

Metachronous Second Primary Malignancies after Head and Neck Cancer in a Korean Cohort (1993-2010)

“…One interesting result was the increased risk of secondary uterine cervical cancers after index oropharyngeal cancer compared to after index non-oropharyngeal cancer in women. Relationships between cancers of the oropharynx and uterine cervix were reported in the US, Canada [ 24 ], and Italy [ 25 ], and our Korean data are in line with these relationships. However, considering that this correlation between two HPV-related cancers was not detected in another study [ 26 ], further detailed evaluation is warranted.…”

Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients

“…Both cervical cancer and precancerous lesions of the cervix are mainly caused by human papilloma virus (HPV) [4,19]. A chronic HPV infection is the most important risk factor for the development of invasive cervical cancer [27].…”

Human Papillomavirus‐Related Oropharyngeal Cancer in Women

“…HPV, a known risk factor for cervical cancer and cancer of the genitourinary tract, has been identified as an important risk factor for oropharyngeal cancer . HPV‐positive oropharyngeal cancer is related to exposure to one of the high‐risk HPV genotypes, most commonly HPV‐16, which is associated with at least 90% of HPV‐positive oropharyngeal cancer diagnoses .…”

“…The virus has been found in semen, saliva, and genital secretions and can be transmitted through small abrasions and tissue trauma during sexual contact. Transmission of HPV during oral‐genital contact can lead to oral/oropharyngeal HPV infection and increase the risk for oropharyngeal cancer . The prevalence of HPV‐positive oropharyngeal cancers is linked to sexual behaviors, with the number of lifetime sexual partners increasing the risk of oropharyngeal HPV infection and cancer .…”

“…There has been one other case in the literature to date of HPV‐16 transmission between partners who both developed oropharyngeal cancer . In another recently published case study, a woman with a history of having cervical dysplasia linked to HPV‐16 was later diagnosed with a lesion in the tonsillar lodge, also positive for HPV‐16 …”