Diagnosis of HPV-associated oropharyngeal squamous cell carcinoma in a middle-income country: report of two new cases

Authors

  • Sibele Nascimento de Aquino Federal University of Juiz de Fora, Applied Health Sciences Post-Graduate Program – Governador Valadares (MG), Brazil. https://orcid.org/0000-0003-3843-3517
  • Hélen Kaline Farias Bezerra University of Campinas, Piracicaba Dental School, Oral Pathology Section, Department of Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0002-5236-8988
  • Brendo Vinícius Rodrigues Louredo University of Campinas, Piracicaba Dental School, Oral Pathology Section, Department of Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0002-5057-4008
  • Márcio Ajudarte Lopes University of Campinas, Piracicaba Dental School, Oral Pathology Section, Department of Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0001-6677-0065
  • Alan Roger Santos-Silva University of Campinas, Piracicaba Dental School, Oral Pathology Section, Department of Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0003-2040-6617
  • Pablo Agustin Vargas University of Campinas, Piracicaba Dental School, Oral Pathology Section, Department of Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0003-1840-4911

DOI:

https://doi.org/10.5327/2525-5711.260

Keywords:

HPV-associated squamous cell carcinoma, Oropharynx, Uvula, Immunohistochemistry, In situ hybridization

Abstract

Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is a distinct subset characterized by better treatment responses and higher survival rates. Clinical and morphological aspects are crucial for diagnosis. Here we report two additional cases of HPV-associated OPSCC. Case 1: A 46-year-old male smoker and alcoholic presented with a 6 cm asymptomatic destructive ulcer involving multiple areas of the oropharynx. Microscopic analysis revealed non-keratinizing squamous cell carcinoma (SCC) with strong and diffuse cytoplasmatic and nuclear positivity for p16 in the tumor cells on IHC and ISH for HPV16/18 revealed the presence of viral DNA in a dot-like pattern. Case 2: A 53-year-old male smoker and alcoholic complained of dysphagia and exhibited erythematous areas in the uvula. Microscopically, a basaloid SCC  was observed. Assessment of p16 expression showed diffuse moderate nuclear and cytoplasmatic positivity and ISH for DNA HPV16/18 also demonstrated dot-like signals. The present cases highlight the clinical and microscopical aspects of HPV-associated OPSCC. Pathologists and clinicians must remain vigilant in identifying HPV-associated OPSCC, even in cases where there is a history of alcohol and tobacco consumption. Assessment of p16 immunohistochemical patterns and ISH analysis are crucial to better understand the scenario of HPV-associated OPSCC in middle-income countries.

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Published

2024-10-30

How to Cite

1.
Nascimento de Aquino S, Farias Bezerra HK, Rodrigues Louredo BV, Ajudarte Lopes M, Santos-Silva AR, Agustin Vargas P. Diagnosis of HPV-associated oropharyngeal squamous cell carcinoma in a middle-income country: report of two new cases. J Oral Diagn [Internet]. 2024 Oct. 30 [cited 2025 Feb. 5];9. Available from: https://joraldiagnosis.com/revista/article/view/260

Issue

Vol. 9 (2024)

Section

Case Report

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Copyright (c) 2024 Sibele Nascimento de Aquino, Hélen Kaline Farias Bezerra, Brendo Vinícius Rodrigues Louredo, Márcio Ajudarte Lopes, Alan Roger Santos-Silva, Pablo Agustin Vargas

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