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Three synchronous HPV-associated squamous cell carcinomas of Waldeyer's ring: Case report and comparison with Slaughter's model of field cancerization

Authors

  • Susan L. McGovern MD, PhD,

    1. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • Michelle D. Williams MD,

    1. Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • Randal S. Weber MD,

    1. Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • Anita Sabichi MD,

    1. Department of Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • Mark S. Chambers DMD, MS,

    1. Department of Dental Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • Jack W. Martin DDS, MS,

    1. Department of Dental Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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  • K. S. Clifford Chao MD

    Corresponding author
    1. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
    Current affiliation:
    1. Department of Radiation Oncology, Columbia and Cornell University, New York, New York 10032
    • Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
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Abstract

Background.

Patients with squamous cell carcinoma (SCC) of the oropharynx have an 8% to 20% risk of a synchronous or metachronous second malignancy. The rate of synchronous lesions in human papillomavirus (HPV)-positive oropharyngeal cancers is unknown.

Methods.

We report the case of a 46-year-old man with 3 simultaneous primary malignancies of Waldeyer's ring: HPV-positive SCC of both tonsils and the nasopharynx, with bilateral neck metastases.

Results.

The patient received induction chemotherapy followed by definitive radiotherapy and remains free of disease at 18 months.

Conclusion.

Comparison with the Slaughter model of field cancerization suggests that HPV-positive SCC of the head and neck may have a distinct mechanism for the development of multifocal disease. Therefore, the emerging population of young patients with head and neck SCC with HPV-positive cancers presents a new opportunity for understanding the molecular origins of synchronous tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009

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