Human Immunodeficiency Virus (HIV) Positive Case with Squamous Cell Larynx Cancer: Difficulties in the Choice of Treatment

Impact of human immunodeficiency virus status on laryngeal cancer survival and locoregional control

“…It is estimated, for example, that the risk of HNSCC is between 1.4 and 4 times greater in PLWH, with the risk of laryngeal SCC being between 2-and 11-fold higher. [3][4][5][6][7][8] PLWH are also diagnosed at a younger age, by about 7-10 years for all HNSCC and 15-20 years for LSCC specifically. 3,5,7,14 Here, we found only a 6-year difference in age of LC diagnosis between PLWH and controls, though among PLWH, the median age of 56 was about 15 years older than in other reports.…”

“…[3][4][5][6][7][8] PLWH are also diagnosed at a younger age, by about 7-10 years for all HNSCC and 15-20 years for LSCC specifically. 3,5,7,14 Here, we found only a 6-year difference in age of LC diagnosis between PLWH and controls, though among PLWH, the median age of 56 was about 15 years older than in other reports. 13 Previous studies have also reported more advanced stage at diagnosis in PLWH compared to controls, though we did not find this to be the case.…”

“…13 Previous studies have also reported more advanced stage at diagnosis in PLWH compared to controls, though we did not find this to be the case. 5,13 There is conflicting evidence regarding whether HIV+ HNSCC represents an etiologically distinct disease process from HNSCC in the general population. 3,15 In favor of such a distinction, HIV+ HNSCC has been found to have a unique mutation pattern in the TP53 tumor suppressor gene.…”

“…2 In fact, the rate of LSCC in PLWH has significantly exceeded, by between 1.4 and 11 times, that of uninfected individuals. [3][4][5][6][7][8] PLWH have multiple unique risk factors-for example, immunosuppression, inflammation, oncogenic virus infection, cART toxicity, and HIV itself-that could potentially modify risk, clinical course, and outcomes of their laryngeal cancer (LC) compared to the general population. 9 So, as the incidence of LSCC increases among PLWH, it becomes increasingly important to fully characterize disease outcomes and compare them to HIV À LSCC in order to assist in prognostication and clinical decision-making.…”

Retroviral Disease and Smoking – A Sinister Combination causing Hyperkeratotic Laryngeal Papilloma

“…1 HPV associated laryngeal papilloma and laryngeal malignancy in particular Kaposi sarcoma and Non-Hodgkin's lymphoma are the most frequent lesions reported pertaining to larynx in HIV infected individuals. 2,3,4 This is possibly due to alteration in cell mediated immunity induced by HPV.Tobacco smoking and alcohol consumption predispose to a variety of laryngeal pathologies like laryngopharyngeal reflux (LPR) (40.62%) followed by chronic laryngitis (25%), vocal fold keratosis (18.75%), Reinke's edema (12.50%), and malignancy (3.12%). 5 Most of the laryngeal pathologies in a chronic smoker present with hoarseness of voice which needs further evaluation on its duration, onset, quality and associated symptoms.Here we present a case of histopathology proven hyperkeratotic papilloma in a HIV infected individual with a history of chronic smoking (60 pack years).…”